Provider Demographics
NPI:1194881151
Name:DESHMUKH, BEENA PATEL (DDS MSD)
Entity type:Individual
Prefix:DR
First Name:BEENA
Middle Name:PATEL
Last Name:DESHMUKH
Suffix:
Gender:F
Credentials:DDS MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GOLFVIEW DENTAL ASSOCIATES
Mailing Address - Street 2:6056 W 159TH ST
Mailing Address - City:OAK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60452
Mailing Address - Country:US
Mailing Address - Phone:708-687-6100
Mailing Address - Fax:708-687-6559
Practice Address - Street 1:GOLFVIEW DENTAL ASSOCIATES
Practice Address - Street 2:6056 W 159TH ST
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452
Practice Address - Country:US
Practice Address - Phone:708-687-6100
Practice Address - Fax:708-687-6559
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist