Edward Lee Beavers, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3926 Issued in TN

Practice address

603 NW Atlantic St
Tullahoma, TN 37388-3536

Phone

(931) 455-3501

NPI assigned

May 21, 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

Other names 1

• Edward Lee Beavers Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194933028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 NW ATLANTIC ST",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373883536",
            "telephone_number": "931-455-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 NW ATLANTIC ST",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373883536",
            "telephone_number": "931-455-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAVERS",
        "first_name": "EDWARD",
        "middle_name": "LEE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "3926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDWARD",
            "last_name": "BEAVERS",
            "middle_name": "LEE",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Regina L Beach
• Joseph Bean, LPC
• Lauren Bean, OT
• Linda Deanne Beard, COTA
• Robert Alan Beasley, MD
• Laura Beckwith Dotson, PMHNP
• Tamara Shea Belinc
• Angela Sherlin Bell, OD
• Catherine Bell
• Mindi Bell, PT

• All providers in Tullahoma, TN
• General Practice Dentistry in Tennessee

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.