MEDICARE: JAMES S. FISHBEIN, DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	1789	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	059397	OTHER	UNITED CONCORDIA
2	020335040NH01	OTHER	ANTHEM BLUE CROSS/BLUE SH
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	XO4589FI	OTHER	MA BLUE CROSS/ BLUE SHIEL

General Provider Information

NPI Number	:	1548346992
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES S. FISHBEIN, DDS

Provider Business Mailing Address
First Line	:	2456 LAFAYETTE RD
Second Line	:
City	:	PORTSMOUTH
State	:	NH
Zip	:	03801-5624
Country	:	US
Telephone Number	:	603-436-9908
Fax Number	:	603-436-1354

Provider Business Practice Location Address
First Line	:	2456 LAFAYETTE RD
Second Line	:
City	:	PORTSMOUTH
State	:	NH
Zip	:	03801-5624
Country	:	US
Telephone Number	:	603-436-9908
Fax Number	:	603-436-1354

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JAMES S FISHBEIN
Credential	:	DDS
Telephone Number	:	603-436-9908

Provider Enumeration Date	:	10/28/2006
Last Update Date	:	08/22/2020

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