Provider Demographics
NPI:1417573700
Name:BEBING, GEOMEL BRIAN VILLAREAL (DMD)
Entity Type:Individual
Prefix:DR
First Name:GEOMEL BRIAN
Middle Name:VILLAREAL
Last Name:BEBING
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 1:14140 MERIDIAN PKWY STE 102
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92518-3043
Mailing Address - Country:US
Mailing Address - Phone:951-777-2805
Mailing Address - Fax:
Practice Address - Street 1:14140 MERIDIAN PKWY STE 102
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92518-3043
Practice Address - Country:US
Practice Address - Phone:951-450-0258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-22
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1049391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice