NPIMap

Organization Active NPI

Kimball & Beecher Group LLC

  • General Practice Dentistry
  • Fairfield, IA
National Provider Identifier
1114729050
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
KIMBALL & BEECHER GROUP LLC
Practice address
106 E Washington Ave
Fairfield, IA 52556-3326
Phone
(641) 472-3147
NPI assigned
Mar 24, 2025
Organization subpart
Yes
Parent organization
KIMBALL & BEECHER GROUP LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Authorized official

Name
Sandy Marie Crock, RDH
Title
Controller
Phone
(319) 235-6287

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

106 E Washington Ave
Fairfield, IA 52556-3326

Mailing address

4015 Hurst Dr
Waterloo, IA 50701-9035
Phone (319) 235-6287

National Provider Directory

National Provider Directory
Tax ID family
Kimball Beecher Berkshire5 organizations share this tax ID, including this one
Part of
Kimball Beecher Berkshire

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

106 E Washington Ave
Fairfield, IA 52556
Phone (641) 472-3147

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1742774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743552000000",
    "number": "1114729050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 HURST DR",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507019035",
            "telephone_number": "319-235-6287",
            "fax_number": "563-293-2495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 E WASHINGTON AVE",
            "city": "FAIRFIELD",
            "state": "IA",
            "postal_code": "525563326",
            "telephone_number": "641-472-3147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBALL & BEECHER GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KIMBALL & BEECHER GROUP LLC",
        "enumeration_date": "2025-03-24",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A",
        "authorized_official_last_name": "CROCK",
        "authorized_official_first_name": "SANDY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "319-235-6287",
        "authorized_official_credential": "RDH"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; 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.