Provider Demographics
NPI:1902812266
Name:DANIEL J. BEITING, D.M.D., P.S.C.
Entity Type:Organization
Organization Name:DANIEL J. BEITING, D.M.D., P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:BEITING
Authorized Official - Suffix:SR
Authorized Official - Credentials:DMD
Authorized Official - Phone:859-341-2234
Mailing Address - Street 1:2617 LEGENDS WAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CRESTVIEW HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-2363
Mailing Address - Country:US
Mailing Address - Phone:859-341-2234
Mailing Address - Fax:859-341-4544
Practice Address - Street 1:2617 LEGENDS WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-2363
Practice Address - Country:US
Practice Address - Phone:859-341-2234
Practice Address - Fax:859-341-4544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY41501223G0001X
KY83661223G0001X
KY440124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Not Answered124Q00000XDental ProvidersDental HygienistGroup - Single Specialty