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NPI Code Detail

MEDICARE: DR. SHEBA BEITLER DMD

MEDICARE:  DR. SHEBA  BEITLER  DMD
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
11223G0001XGeneral Practice Dentistry044326NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1891768131
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHEBA BEITLER DMD
Provider Business Mailing Address
First Line : 320 PENNINGTON AVE
Second Line :
City : PASSAIC
State : NJ
Zip : 07055-3406
Country : US
Telephone Number : 973-458-8053
Fax Number : 973-458-0182
Provider Business Practice Location Address
First Line : 234 HEWES ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11211-8141
Country : US
Telephone Number : 718-782-9425
Fax Number : 718-782-9425
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2006
Last Update Date : 07/09/2007

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