Provider Demographics
NPI:1548050545
Name:BETHELVIEW FAMILY DENTISTRY LLC
Entity type:Organization
Organization Name:BETHELVIEW FAMILY DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHALATHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KANCHARLA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:484-366-3775
Mailing Address - Street 1:6030 BETHELVIEW RD
Mailing Address - Street 2:UNIT 201
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040
Mailing Address - Country:US
Mailing Address - Phone:470-560-3989
Mailing Address - Fax:
Practice Address - Street 1:6030 BETHELVIEW RD
Practice Address - Street 2:UNIT 201
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040
Practice Address - Country:US
Practice Address - Phone:470-560-3989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty