Provider Demographics
NPI:1013923515
Name:BEITING, DANIEL JOSEPH SR (DMD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JOSEPH
Last Name:BEITING
Suffix:SR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY41501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice