NPIMap

Organization Active NPI

Deborah L. Beaty D.D.S., P.C.

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1053587717
Registry record updated May 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
060006022 Issued in IL
Legal business name
DEBORAH L. BEATY D.D.S., P.C.
Practice address
111 N Wabash Ave Ste 1921
Chicago, IL 60602-2970
Phone
(312) 332-4424
Fax
(312) 332-4423
NPI assigned
May 2, 2008
Last updated
May 2, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2008

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

Authorized official

Name
Dr. Deborah L. Beaty, DDSNPI 1689846495
Title
Dentist
Phone
(312) 332-4424

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 060006022 IL Primary

Addresses

Primary practice location

111 N Wabash Ave Ste 1921
Chicago, IL 60602-2970

Mailing address

111 N Wabash Ave
Suite 1921
Chicago, IL 60602
Phone (312) 332-4424

Other identifiers 1

IdentifierTypeStateIssuer
060006022OtherILPROFESSIONAL CORPORATION/DENTAL

National Provider Directory

National Provider Directory

Locations

111 N Wabash Ave
Ste 1921
Chicago, IL 60602
Phone (312) 332-4424

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1209686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209686400000",
    "number": "1053587717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N WABASH AVE",
            "address_2": "SUITE 1921",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60602",
            "telephone_number": "312-332-4424",
            "fax_number": "312-332-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N WABASH AVE STE 1921",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606022970",
            "telephone_number": "312-332-4424",
            "fax_number": "312-332-4423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBORAH L. BEATY D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-02",
        "last_updated": "2008-05-02",
        "status": "A",
        "authorized_official_last_name": "BEATY",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "312-332-4424",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "060006022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL CORPORATION/DENTAL",
            "identifier": "060006022",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.