Michael George Bedwell, GENERAL DENTIST

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12540 Issued in TX

Practice address

1111 Kinwest Pkwy
Suite 150
Irving, TX 75063-3409

Phone

(214) 461-0425

Fax

(214) 461-0429

NPI assigned

Dec 28, 2006

Sex

Male

Sole proprietor

Yes

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

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• HK Nova Dental PLLC

  • General Practice Dentistry
  • Irving, TX
  • NPI 1366282998
  NPD (past)

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093871014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 KINWEST PKWY",
            "address_2": "SUITE 150",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750633409",
            "telephone_number": "214-461-0425",
            "fax_number": "214-461-0429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 KINWEST PKWY",
            "address_2": "SUITE 150",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750633409",
            "telephone_number": "214-461-0425",
            "fax_number": "214-461-0429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDWELL",
        "first_name": "MICHAEL",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "GENERAL DENTIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "12540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kevan S Beijan, M.ED., LPC-S
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• General Practice Dentistry in Irving, TX
• Providers in Irving, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.