Provider Demographics
NPI:1467591826
Name:BEISCHEL, DOUGLAS OWEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:OWEN
Last Name:BEISCHEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7125 E LINCOLN DR
Mailing Address - Street 2:SUITE B108
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-4429
Mailing Address - Country:US
Mailing Address - Phone:480-948-1450
Mailing Address - Fax:480-922-8601
Practice Address - Street 1:7125 E LINCOLN DR
Practice Address - Street 2:SUITE B108
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253-4429
Practice Address - Country:US
Practice Address - Phone:480-948-1450
Practice Address - Fax:480-922-8601
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD43981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
826546OtherUNITED CONCORDIA