Provider Demographics
NPI:1225384837
Name:MICHAEL J. BEZBATCHENKO, D.D.S.
Entity Type:Organization
Organization Name:MICHAEL J. BEZBATCHENKO, D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:BEZBATCHENKO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-890-7734
Mailing Address - Street 1:149 W SCHROCK RD
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-2831
Mailing Address - Country:US
Mailing Address - Phone:614-890-7734
Mailing Address - Fax:614-890-4518
Practice Address - Street 1:149 W SCHROCK RD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-2831
Practice Address - Country:US
Practice Address - Phone:614-890-7734
Practice Address - Fax:614-890-4518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH15998261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental