John Harlo Beschenbossel, DDS

Individual provider Active NPI General Practice Dentistry · Washington, DC

NPI 1477838308 · NPPES record last updated Oct 11, 2011

Key facts

NPI
1477838308
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2904 (DC)
Practice address
5225 Wisconsin Ave NW
Suite 511
Washington, DC 20015-2014
Phone
(202) 966-0620
Fax
(202) 966-1509
NPI assigned
Oct 11, 2011
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2904DCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Carol a Blake, DDS, PLLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2904 DC Yes

Addresses

Primary practice location

5225 Wisconsin Ave NW
Suite 511
Washington, DC 20015-2014

Mailing address

5225 Wisconsin Ave NW
Suite 511
Washington, DC 20015-2014
Phone (202) 966-0620

Other providers in Washington, DC

All providers in Washington, DC · General Practice Dentistry in District of Columbia

Sources for this page

Verify at the official NPI Registry.