Provider Demographics
NPI:1558585216
Name:BECK, DAVID A I (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:BECK
Suffix:I
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 1:5112 CEDAR VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040
Mailing Address - Country:US
Mailing Address - Phone:513-204-0054
Mailing Address - Fax:513-204-3498
Practice Address - Street 1:5112 CEDAR VILLAGE DR
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040
Practice Address - Country:US
Practice Address - Phone:513-204-0054
Practice Address - Fax:513-204-3498
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0216711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice