NPIMap

Organization Active NPI

Brandon E Beaver DDS PC

Doing business as Westside Family Dentistry

  • Dentist
  • Durant, OK
National Provider Identifier
1174741474
Registry record updated Jun 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5597 Issued in OK
Legal business name
BRANDON E BEAVER DDS PC
Doing business as
Westside Family Dentistry
Practice address
2915 Westside Drive
Durant, OK 74701-2028
Phone
(580) 924-1234
Fax
(580) 920-2082
NPI assigned
Apr 23, 2007
Last updated
Jun 16, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2015

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

Authorized official

Name
Tiffany L Langley
Title
Office Manager
Phone
(580) 924-1234

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3469 OK
Dentist 122300000X 5597 OK Primary

Addresses

Primary practice location

2915 Westside Drive
Durant, OK 74701-2028

Mailing address

2915 Westside Drive
Durant, OK 74701-2028
Phone (580) 924-1234

Other names 1

  • Westside Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

2915 Westside Dr
Durant, OK 74701
Phone (580) 924-1234

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434412800000",
    "number": "1174741474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 WESTSIDE DRIVE",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747012028",
            "telephone_number": "580-924-1234",
            "fax_number": "580-920-2082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 WESTSIDE DRIVE",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747012028",
            "telephone_number": "580-924-1234",
            "fax_number": "580-920-2082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANDON E BEAVER DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2015-06-16",
        "status": "A",
        "authorized_official_last_name": "LANGLEY",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "580-924-1234"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "3469",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "5597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westside Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Durant, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; 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.