Louis Anthony Beaudette, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

016-0000588 Issued in VT

Practice address

108 East Main Street
Wilmington, VT 05363

Phone

(802) 464-5817

Fax

(802) 464-1103

NPI assigned

Jul 13, 2006

Last updated

Jul 8, 2007By 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 1

Addresses

Other identifiers 1

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114943479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 EAST MAIN ST.",
            "address_2": "BOX 937",
            "city": "WILMINGTON",
            "state": "VT",
            "postal_code": "053630937",
            "telephone_number": "802-464-5817",
            "fax_number": "802-464-1103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 EAST MAIN STREET",
            "city": "WILMINGTON",
            "state": "VT",
            "postal_code": "05363",
            "telephone_number": "802-464-5817",
            "fax_number": "802-464-1103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUDETTE",
        "first_name": "LOUIS",
        "middle_name": "ANTHONY",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VT",
            "license": "016-0000588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001693",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Wilmington, VT
• Providers in Wilmington, VT by specialty
• General Practice Dentistry in Vermont

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.