Provider Demographics
NPI:1609568823
Name:BECK, BELLA (DMD)
Entity Type:Individual
Prefix:
First Name:BELLA
Middle Name:
Last Name:BECK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:BERMET
Other - Middle Name:
Other - Last Name:BEKMURATOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22158 BELLA LAGO DR APT 2202
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-4824
Mailing Address - Country:US
Mailing Address - Phone:650-417-8982
Mailing Address - Fax:
Practice Address - Street 1:3003 W YAMATO RD STE C5
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-5337
Practice Address - Country:US
Practice Address - Phone:561-566-5443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN278841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice