1730419789 NPI number — DAVID A BECK DDS & TROY R PEARCE DMD, INC.

Table of content: DR. DAVID LEWIS LEBELL MD (NPI 1902904493)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730419789 NPI number — DAVID A BECK DDS & TROY R PEARCE DMD, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DAVID A BECK DDS & TROY R PEARCE DMD, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DAVID BECK DDS, INC
Provider Other Organization Name Type Code:
4
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:
1730419789
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/26/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
425 WALNUT ST
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45202
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-651-0110
Provider Business Mailing Address Fax Number:
513-651-9036

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
425 WALNUT ST
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-651-0110
Provider Business Practice Location Address Fax Number:
513-651-9036
Provider Enumeration Date:
01/13/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PEARCE
Authorized Official First Name:
TROY
Authorized Official Middle Name:
RAYMOND
Authorized Official Title or Position:
VICE PRESIDENT/OWNER
Authorized Official Telephone Number:
513-651-0110

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  22732 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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