Active NPI
Kaseem Beck, DMD
- Dentist
- Lawrenceville, GA
National Provider Identifier
1194373621
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN015877
- Practice address
- Gwinnett Family Dental Care
3455 Lawrenceville Hwy
Lawrenceville, GA 30044 - Phone
- (770) 921-1115
- NPI assigned
- Aug 28, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN015877 | GA | Primary |
Addresses
Primary practice location
Gwinnett Family Dental Care
3455 Lawrenceville Hwy
Lawrenceville, GA 30044
Mailing address
5730 Martin Grove Dr NW
Lilburn, GA 30047-6078
Phone (770) 728-2560
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN015877 | GA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gwinnett Family Dental Care | Dentist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- Lawrenceville, GA
- NPI 1316112360
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566950400000",
"number": "1194373621",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5730 MARTIN GROVE DR NW",
"city": "LILBURN",
"state": "GA",
"postal_code": "300476078",
"telephone_number": "770-728-2560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "GWINNETT FAMILY DENTAL CARE",
"address_2": "3455 LAWRENCEVILLE HWY",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "30044",
"telephone_number": "770-921-1115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECK",
"first_name": "KASEEM",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-08-28",
"last_updated": "2019-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "GA",
"license": "DN015877",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.