Provider Demographics
NPI:1306837059
Name:BEGUN, RIMMA Y (DDS)
Entity Type:Individual
Prefix:DR
First Name:RIMMA
Middle Name:Y
Last Name:BEGUN
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 1:2433 HIGHWAY 516
Mailing Address - Street 2:STE C
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-1892
Mailing Address - Country:US
Mailing Address - Phone:732-607-9005
Mailing Address - Fax:732-607-9006
Practice Address - Street 1:2433 HIGHWAY 516
Practice Address - Street 2:STE C
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-1892
Practice Address - Country:US
Practice Address - Phone:732-607-9005
Practice Address - Fax:732-607-9006
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI19302122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7505205Medicare ID - Type Unspecified