Nathan Luteru Beck, DDS

Individual provider Active NPI General Practice Dentistry · Bishop, CA

NPI 1306364112 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1306364112
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
64618 (CA)
Practice address
625 Keough St
Bishop, CA 93514-2533
Phone
(760) 258-7524
NPI assigned
Aug 31, 2017
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20171010001709 CA Order and Referring Only - Dentist
Practitioner - Dentist
5395010805

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 64618 CA Yes

Addresses

Primary practice location

625 Keough St
Bishop, CA 93514-2533

Mailing address

625 Keough St
Bishop, CA 93514-2533
Phone (760) 258-7524

Other providers in Bishop, CA

All providers in Bishop, CA · General Practice Dentistry in California

Sources for this page

Verify at the official NPI Registry.