Provider Demographics
NPI:1407872492
Name:BECKER, STEVEN J (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:BECKER
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 1:1-B RIVERDALE DRIVE
Mailing Address - Street 2:1-B
Mailing Address - City:HAMPTON
Mailing Address - State:VI
Mailing Address - Zip Code:23666-3597
Mailing Address - Country:US
Mailing Address - Phone:757-838-7879
Mailing Address - Fax:757-838-7879
Practice Address - Street 1:1-B RIVERDALE DRIVE
Practice Address - Street 2:1-B
Practice Address - City:HAMPTON
Practice Address - State:VI
Practice Address - Zip Code:23666-3597
Practice Address - Country:US
Practice Address - Phone:757-838-7879
Practice Address - Fax:757-838-7879
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401004597122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist