Melisa Raquel Beckley, D.D.S.

Individual provider Active NPI General Practice Dentistry · Redlands, CA

NPI 1962697516 · NPPES record last updated Sep 6, 2007

Key facts

NPI
1962697516
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
47594 (CA)
Practice address
245 Terracina Blvd
Redlands, CA 92373-4852
Phone
(909) 798-4111
Fax
(909) 798-4119
NPI assigned
Sep 6, 2007
Sex
Female
Sole proprietor
Yes

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
47594CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Beckley General Dentistry, Professional Corporation Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 47594 CA Yes

Addresses

Primary practice location

245 Terracina Blvd
Redlands, CA 92373-4852

Mailing address

245 Terracina Blvd
Redlands, CA 92373-4852
Phone (909) 798-4111

Other providers in Redlands, CA

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

Sources for this page

Verify at the official NPI Registry.