Provider Demographics
NPI:1497896088
Name:BECKER, ANNE ELIZABETH (DDS)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:ELIZABETH
Last Name:BECKER
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 1:6200 ANTIOCH ST
Mailing Address - Street 2:SUITE #201
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-2951
Mailing Address - Country:US
Mailing Address - Phone:510-339-0277
Mailing Address - Fax:510-339-0297
Practice Address - Street 1:6200 ANTIOCH ST
Practice Address - Street 2:SUITE #201
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-2951
Practice Address - Country:US
Practice Address - Phone:510-339-0277
Practice Address - Fax:510-339-0297
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA307611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice