DR. DONALD ALAN BETHEA D.D.S. NPI 1417053646

NPI Information

NPI: 1417053646
Provider Name: DR. DONALD ALAN BETHEA, D.D.S.
Classification: Dentist - 1223P0221X
Entity Type: Individual

Specialization: Pediatric Dentistry

Address:
410 LISTER ST
WAYCROSS, GA
ZIP 31501
Phone: (912) 285-1218
Get Directions

DR. Donald Alan Bethea, D.D.S. is a pediatric dentistry dentist in Waycross, GA. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. DR. Donald Alan Bethea, D.D.S. NPI is 1417053646. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

410 LISTER ST
WAYCROSS, GA
ZIP 31501-226
Phone: (912) 285-1218
Fax: (912) 285-9518

The enumeration date for this NPI number is 9/15/2006 and was last updated on 6/18/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223P0221X	Dentist	Pediatric Dentistry	DS6972	TENNESSEE	No
2	1223P0221X	Dentist	Pediatric Dentistry	DN011225	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	003143408A	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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