Provider Demographics
NPI:1477838308
Name:BESCHENBOSSEL, JOHN HARLO (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HARLO
Last Name:BESCHENBOSSEL
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 1:5225 WISCONSIN AVE NW
Mailing Address - Street 2:SUITE 511
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-2014
Mailing Address - Country:US
Mailing Address - Phone:202-966-0620
Mailing Address - Fax:202-966-1509
Practice Address - Street 1:5225 WISCONSIN AVE NW
Practice Address - Street 2:SUITE 511
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-2014
Practice Address - Country:US
Practice Address - Phone:202-966-0620
Practice Address - Fax:202-966-1509
Is Sole Proprietor?:No
Enumeration Date:2011-10-11
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC29041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice