Ted Beauchamp, DDS LLC

Primary specialty

EndodonticsTaxonomy code 1223E0200X

Legal business name

TED BEAUCHAMP, DDS LLC

Practice address

853 Medical Dr Ste 112
Wentzville, MO 63385-3825

Phone

(636) 487-0122

NPI assigned

Dec 18, 2023

Organization subpart

No

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

Authorized official

Name

Ted Michael Beauchamp, DDSNPI 1518198019

Title

Doctor/Owner

Phone

(636) 487-0122

Specialties & licenses 1

Addresses

Other names 1

• Beacon Endodontics Doing business as

Locations

Practitioners 1

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

• Ted Michael Beauchamp, DDS

  • Endodontics
  • Wentzville, MO
  • NPI 1518198019
  NPD Authorized official

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

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702857600000",
    "number": "1124896220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "853 MEDICAL DR STE 112",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633853825",
            "telephone_number": "636-487-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "853 MEDICAL DR STE 112",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633853825",
            "telephone_number": "636-487-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TED BEAUCHAMP, DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-18",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A",
        "authorized_official_last_name": "BEAUCHAMP",
        "authorized_official_first_name": "TED",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "636-487-0122",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beacon Endodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Synergy Chiropractic Center, LLC
• Mark D Taber, M.D.
• Paul A Tapia, MD
• Nathan Gabriel Taylor, LCSW
• Savanna Elizabeth Taylor, PLPC
• Alison Marie Tempelmeier, LPC
• Anna Lee Templeton
• Keri M Teter, LPC
• Jonathan Tyler Thayer, OD
• The Child Advocacy Center of Northeast Mo

• Endodontics in Wentzville, MO
• Providers in Wentzville, MO by specialty
• Endodontics in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.