# BEAVER VALLEY DENTAL, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548449176
- **Authorized official:** TRICIA CIARIMBOLI (REGIONAL MANAGER)
- **Authorized official phone:** (724) 266-2099

## Contact information

- **Practice address:** 546 MERCHANT ST, AMBRIDGE, PA 15003-2463
- **Practice address phone:** (724) 266-2099
- **Practice address fax:** (724) 266-5388
- **Mailing address:** 546 MERCHANT ST, AMBRIDGE, PA 15003-2463

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DS030094L | PA | Yes |
| 1223G0001X | General Practice Dentistry | DS036432 | PA | — |

## Other

- **Enumeration date:** 10/31/2007
- **Last updated:** 10/31/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0017686540006 | — | PA |
| 05 | — | 1018235160001 | — | PA |