Diane Beckius Archbold, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D13893 Issued in MN

Practice address

310 W Losey St
Scott Afb, IL 62225-5250

Phone

(618) 256-6655

NPI assigned

Aug 16, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1502841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502841600000",
    "number": "1063938546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 OAK RIDGE CT",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622693004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W LOSEY ST",
            "city": "SCOTT AFB",
            "state": "IL",
            "postal_code": "622255250",
            "telephone_number": "618-256-6655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHBOLD",
        "first_name": "DIANE",
        "middle_name": "BECKIUS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-16",
        "last_updated": "2017-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D13893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 375TH Medgrp-Scott
• 375TH Medgrp-Scott
• Hattie D Alexander, D.O.
• Nicole Andreoli, MT(ASCP)
• Kristine Eva Andrews, M.D.
• Nikki L Beadle, O.D
• Kelly Campbell Bean, DMD
• Margaret Ruth Bergmann, PSYD, LPC
• Angelic Berry, M.ED, M.S.
• Susannah Frances Bouchard, WHNP

• General Practice Dentistry in Scott Afb, IL
• Providers in Scott Afb, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2017; 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.