Provider Demographics
NPI:1801673470
Name:BAHAR, REBECCA LAUREN (DDS)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:LAUREN
Last Name:BAHAR
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 1:5 GRANDVIEW AVE APT 807
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15211-1618
Mailing Address - Country:US
Mailing Address - Phone:647-880-7766
Mailing Address - Fax:
Practice Address - Street 1:1 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-2953
Practice Address - Country:US
Practice Address - Phone:724-219-4133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-08
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401418595122300000X
PADS0445711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist