Provider Demographics
NPI:1659824423
Name:ZEMBIEC-WHEELER, BETHANY (DDS)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:ZEMBIEC-WHEELER
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 1:520 DREAM VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:NY
Mailing Address - Zip Code:14414-1472
Mailing Address - Country:US
Mailing Address - Phone:585-226-3113
Mailing Address - Fax:
Practice Address - Street 1:520 DREAM VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:NY
Practice Address - Zip Code:14414-1472
Practice Address - Country:US
Practice Address - Phone:585-226-3113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-28
Last Update Date:2019-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY0597661122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program