Provider Demographics
NPI:1821448515
Name:VANBEEK, MATTHEW SCOTT (DDS)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:SCOTT
Last Name:VANBEEK
Suffix:
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 1:6448 COLLEGE RD
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-3290
Mailing Address - Country:US
Mailing Address - Phone:630-983-8700
Mailing Address - Fax:630-983-8512
Practice Address - Street 1:6448 COLLEGE RD
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-3290
Practice Address - Country:US
Practice Address - Phone:630-983-8700
Practice Address - Fax:630-983-8512
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190306871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice