Individual provider Active NPI

Beth Borden, BETH BORDEN, D.D.S.

  • General Practice Dentistry
  • Summerfield, NC
National Provider Identifier
1063725679
Registry record updated Jul 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7957 Issued in NC
Practice address
1017 NC Highway 150 W
Summerfield, NC 27358-9074
Phone
(336) 644-2770
Fax
(336) 644-2778
NPI assigned
Jul 23, 2010
Last updated
Jul 23, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7957 NC Primary

Addresses

Primary practice location

1017 NC Highway 150 W
Summerfield, NC 27358-9074

Mailing address

1017 NC Highway 150 W
Summerfield, NC 27358-9074
Phone (336) 644-2770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20260526002790 NC Practitioner - Dentist 8224062484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Ohio State University College of Dentistry, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

300 E Wendover Ave
Attn Payor Enrollment 2ND Floor
Greensboro, NC 27401-1221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7957NCMDProfessional Counselor

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1279843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279843200000",
    "number": "1063725679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 NC HIGHWAY 150 W",
            "city": "SUMMERFIELD",
            "state": "NC",
            "postal_code": "273589074",
            "telephone_number": "336-644-2770",
            "fax_number": "336-644-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 NC HIGHWAY 150 W",
            "city": "SUMMERFIELD",
            "state": "NC",
            "postal_code": "273589074",
            "telephone_number": "336-644-2770",
            "fax_number": "336-644-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDEN",
        "first_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "BETH BORDEN, D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-23",
        "last_updated": "2010-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "7957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerfield, NC

Sources for this page

Verify at the official NPI Registry.