Provider Demographics
NPI:1134215908
Name:BELL, PORTIA J (DDS)
Entity type:Individual
Prefix:DR
First Name:PORTIA
Middle Name:J
Last Name:BELL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2710 CROSSROADS PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-3442
Mailing Address - Country:US
Mailing Address - Phone:614-471-1161
Mailing Address - Fax:614-471-2586
Practice Address - Street 1:2710 CROSSROADS PLAZA DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-3442
Practice Address - Country:US
Practice Address - Phone:614-471-1161
Practice Address - Fax:614-471-2586
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH177751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0569433Medicaid