Provider Demographics
NPI:1154974426
Name:BEELER, EMERI JIMENEZ (DMD)
Entity type:Individual
Prefix:
First Name:EMERI
Middle Name:JIMENEZ
Last Name:BEELER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-2825
Mailing Address - Country:US
Mailing Address - Phone:360-452-9744
Mailing Address - Fax:855-291-6217
Practice Address - Street 1:104 W 3RD ST
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-2825
Practice Address - Country:US
Practice Address - Phone:360-452-9744
Practice Address - Fax:855-291-6217
Is Sole Proprietor?:No
Enumeration Date:2019-07-16
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60976735122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist