Douglas James Beazer, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D 3057 Issued in ID

Practice address

6526 Main St
Bonners Ferry, ID 83805-8521

Phone

(208) 267-7509

NPI assigned

Jun 24, 2009

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245801600000",
    "number": "1194953588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6526 MAIN ST",
            "city": "BONNERS FERRY",
            "state": "ID",
            "postal_code": "838058521",
            "telephone_number": "208-267-7509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6526 MAIN ST",
            "city": "BONNERS FERRY",
            "state": "ID",
            "postal_code": "838058521",
            "telephone_number": "208-267-7509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAZER",
        "first_name": "DOUGLAS",
        "middle_name": "JAMES",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-24",
        "last_updated": "2009-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D 3057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Art of Redirection Counseling
• Didier Louis Balcaen, R.P.T.
• Mark R Barker, OD
• Heather Bartlett, APRN -PMHNP
• Katherine Ann Beal, RN
• Laura Marie Beazer, LMSW
• Mark Heber Beazer, D.M.D
• Gina M. Beck, L.C.S.W.
• Jackson Joseph Bell, DO
• Clifford Boyd Bellmore, RPH

• General Practice Dentistry in Bonners Ferry, ID
• Providers in Bonners Ferry, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2009; 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.