1629274261 NPI number — DR. JOSEPH ANTONIO BELSITO DDS FAGD

Table of content: DR. JOSEPH ANTONIO BELSITO DDS FAGD (NPI 1629274261)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629274261 NPI number — DR. JOSEPH ANTONIO BELSITO DDS FAGD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BELSITO
Provider First Name:
JOSEPH
Provider Middle Name:
ANTONIO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS FAGD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629274261
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2095 WYANDOTTE ST W
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WINDSOR
Provider Business Mailing Address State Name:
ONT
Provider Business Mailing Address Postal Code:
N9B1J8
Provider Business Mailing Address Country Code:
CA
Provider Business Mailing Address Telephone Number:
519-258-1240
Provider Business Mailing Address Fax Number:
519-258-3107

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2095 WYANDOTTE ST W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WINDSOR
Provider Business Practice Location Address State Name:
ONT
Provider Business Practice Location Address Postal Code:
N9B1J8
Provider Business Practice Location Address Country Code:
CA
Provider Business Practice Location Address Telephone Number:
519-258-1240
Provider Business Practice Location Address Fax Number:
519-258-3107
Provider Enumeration Date:
06/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  0610947 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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