Provider Demographics
NPI:1669847463
Name:BESHAY, MAGDY
Entity Type:Individual
Prefix:
First Name:MAGDY
Middle Name:
Last Name:BESHAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23220 CHAGRIN BLVD APT 400
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5463
Mailing Address - Country:US
Mailing Address - Phone:703-300-7746
Mailing Address - Fax:
Practice Address - Street 1:1129 E AURORA RD STE 102
Practice Address - Street 2:
Practice Address - City:MACEDONIA
Practice Address - State:OH
Practice Address - Zip Code:44056-1988
Practice Address - Country:US
Practice Address - Phone:703-300-7746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-04
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRES.36541223E0200X
OH30.0255481223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics