Provider Demographics
NPI:1003905373
Name:BELLIOS, GEORGE G (DMD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:G
Last Name:BELLIOS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5866 ELLSWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-1738
Mailing Address - Country:US
Mailing Address - Phone:412-244-5288
Mailing Address - Fax:412-344-4388
Practice Address - Street 1:3247 W LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15216-2319
Practice Address - Country:US
Practice Address - Phone:412-344-5288
Practice Address - Fax:412-344-4388
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0284191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01512000OtherTAX ID NUMBER
PA015192OtherUNITED CONCORDIA PROVIDER