Individual provider Active NPI

Andrea R Beckford, DDS

  • Dentist
  • Berrien Springs, MI
National Provider Identifier
1043316557
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12013410A Issued in IN
Practice address
9045 US Highway 31
Berrien Springs, MI 49103-1804
Phone
(989) 533-1888
Fax
(269) 471-9232
NPI assigned
Sep 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1023 GU
Dentist 122300000X 2901022137 MI
Dentist 122300000X 12013410A IN Primary

Addresses

Primary practice location

9045 US Highway 31
Berrien Springs, MI 49103-1804

Mailing address

9045 US Highway 31 Ste 1
Berrien Springs, MI 49103-1804
Phone (269) 471-5244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200812001072 IN Practitioner - Dentist 8921393265 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1023GUMDDentist
12013410AINMDDentist
2901022137MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Andrea R Beckford DDS Mba PLLC Current Accepting new patients
Mishawaka Sleep Inc Dentist CurrentSince Jul 1, 2020 Accepting new patients
Richard L. Beckermeyer, D. D. S., P.C. Past Accepting new patients
Periza Zaninovic DDS PC PastSince Mar 20, 2022 Accepting new patients

Locations

11825 State Route 40
Dunlap, IL 61525
Phone (309) 243-1541

11825 State Route 40
Ste 100
Dunlap, IL 61525
Phone (309) 243-8980

230 E Day Rd
Ste 150
Mishawaka, IN 46545
Phone (574) 231-6190

9045 US Highway 31
Ste 1
Berrien Springs, MI 49103

9045 US Highway 31
Berrien Springs, MI 49103
Phone (269) 473-2222

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1043316557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9045 US HIGHWAY 31 STE 1",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491031804",
            "telephone_number": "269-471-5244",
            "fax_number": "269-471-9232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9045 US HIGHWAY 31",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491031804",
            "telephone_number": "989-533-1888",
            "fax_number": "269-471-9232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKFORD",
        "first_name": "ANDREA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GU",
            "license": "1023",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901022137",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12013410A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berrien Springs, MI

Sources for this page

Verify at the official NPI Registry.