Paul Clinton Becker, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9788 Issued in MN

Practice address

1121 Town Centre Dr Ste 200
Eagan, MN 55123-1217

Phone

(651) 454-4771

NPI assigned

Apr 2, 2007

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

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Smile Design Family Dentistry

  • Dentist
  • Eagan, MN
  • NPI 1437369105
  NPD (past) Authorized official
• Modern Dental Professionals Minnesota PC

  • General Practice Dentistry
  • Eagan, MN
  • NPI 1255639696

  General Practice

  NPD (past)

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164543823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 WHITE OAK CIR",
            "city": "LONG LAKE",
            "state": "MN",
            "postal_code": "553569747",
            "telephone_number": "952-473-2391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 TOWN CENTRE DR STE 200",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551231217",
            "telephone_number": "651-454-4771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "PAUL",
        "middle_name": "CLINTON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "9788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bears Counseling PLLC
• Tyler Beauchamp, LMT
• Sheri Ann Beaupre, PHARM D., RPH
• Samantha Beck
• Kara Becker, OTR/L
• Candice Beckham Chasnoff, LMFT
• Emily Bedker
• Danielle Mariah Beebe, NP
• Martha Beenken, MSW., LICSW.
• Behavior Solutions Plus, PA

• All providers in Eagan, MN
• General Practice Dentistry in Minnesota

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.