Ralf Beilhardt, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3240 Issued in AR

Practice address

10590 Enduring Freedom Dr
Fort Drum, NY 13602-5503

Phone

(315) 772-4342

NPI assigned

May 27, 2005

Last updated

Jul 16, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

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": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1104829761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DENTAL HEALTH ACTIVITY",
            "address_2": "10590 ENDURING FREEDOM DRIVE",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "13602",
            "telephone_number": "315-772-4342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10590 ENDURING FREEDOM DR",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136025503",
            "telephone_number": "315-772-4342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEILHARDT",
        "first_name": "RALF",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2010040599",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "3240",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Katherine Barr, ATC, LAT, MSAT
• Alec Barrowcliff
• Alfred Michael Babia Barrozo, PA-C
• Michael Baxter
• Britton Sterling Beckstead, DDS
• Matthew Todd Bell, PSY.D.
• Todd L. Benham, PSYD, ABPP
• Dianna L Bennett, LMSW
• Jamie Michael Bennett, LCSWA
• Kayla Christine Bentz

• General Practice Dentistry in Fort Drum, NY
• Providers in Fort Drum, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.