Provider Demographics
NPI:1093688657
Name:SCHENECTADY PEDIATRIC DENTISTRY
Entity type:Organization
Organization Name:SCHENECTADY PEDIATRIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISBECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-469-3909
Mailing Address - Street 1:1019 KEYES AVE
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12309-5749
Mailing Address - Country:US
Mailing Address - Phone:518-545-4040
Mailing Address - Fax:518-203-1548
Practice Address - Street 1:1019 KEYES AVE
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12309-5749
Practice Address - Country:US
Practice Address - Phone:518-545-4040
Practice Address - Fax:518-203-1548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty