Provider Demographics
NPI:1225107741
Name:BEVAN, CLAUDIA KAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:CLAUDIA
Middle Name:KAY
Last Name:BEVAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5296 PARK DR
Mailing Address - Street 2:
Mailing Address - City:VERMILION
Mailing Address - State:OH
Mailing Address - Zip Code:44089-1419
Mailing Address - Country:US
Mailing Address - Phone:440-930-5233
Mailing Address - Fax:440-930-5234
Practice Address - Street 1:424 AVON BELDEN RD
Practice Address - Street 2:
Practice Address - City:AVON LAKE
Practice Address - State:OH
Practice Address - Zip Code:44012-2295
Practice Address - Country:US
Practice Address - Phone:440-930-5233
Practice Address - Fax:440-930-5234
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH197911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice