Individual provider Active NPI

Beverly Ann Rice, D.D.S.

  • General Practice Dentistry
  • Dallas, TX
National Provider Identifier
1124207030
Registry record updated Jan 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
23521 Issued in TX
Practice address
3910 Gaston Ave Ste 175
Dallas, TX 75246-1504
Phone
(214) 257-1082
Fax
(215) 823-2326
NPI assigned
Oct 26, 2007
Last updated
Jan 25, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 23521 TX Primary

Addresses

Primary practice location

3910 Gaston Ave Ste 175
Dallas, TX 75246-1504

Mailing address

PO Box 1168
Anniston, AL 36202-1168
Phone (256) 741-7340

Other identifiers 1

IdentifierTypeStateIssuer
1898827MedicaidTX

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160111001218 TX Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 7517269350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23521TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485302400000",
    "number": "1124207030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1168",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362021168",
            "telephone_number": "256-741-7340",
            "fax_number": "256-741-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 GASTON AVE STE 175",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461504",
            "telephone_number": "214-257-1082",
            "fax_number": "215-823-2326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICE",
        "first_name": "BEVERLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-26",
        "last_updated": "2017-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1898827",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.