Active NPI
William Johnston Beard III, D.D.S.
- Dentist
- Milton, GA
National Provider Identifier
1104800663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 9221
- Practice address
- 12220 Birmingham Hwy
BLDG 100
Milton, GA 30004-4186 - Phone
- (770) 664-5600
- NPI assigned
- Nov 30, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 9221 | GA | Primary |
Addresses
Primary practice location
12220 Birmingham Hwy
BLDG 100
Milton, GA 30004-4186
Mailing address
12220 Birmingham Hwy
BLDG 100
Milton, GA 30004-4186
Phone (770) 664-5600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150623001126 | GA | Order and Referring Only - Oral Surgery | 2365753985 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432512000000",
"number": "1104800663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12220 BIRMINGHAM HWY",
"address_2": "BLDG 100",
"city": "MILTON",
"state": "GA",
"postal_code": "300044186",
"telephone_number": "770-664-5600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12220 BIRMINGHAM HWY",
"address_2": "BLDG 100",
"city": "MILTON",
"state": "GA",
"postal_code": "300044186",
"telephone_number": "770-664-5600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEARD",
"first_name": "WILLIAM",
"middle_name": "JOHNSTON",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-30",
"last_updated": "2015-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "GA",
"license": "9221",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2015; 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.