NPIMap

Organization Active NPI

North Beeline Dental LLC

  • General Practice Dentistry
  • Payson, AZ
National Provider Identifier
1205503299
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
NORTH BEELINE DENTAL LLC
Practice address
712 N Beeline Hwy
Payson, AZ 85541-3706
Phone
(928) 474-4581
NPI assigned
Aug 26, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Authorized official

Name
Faith Gaskins
Title
Credentialing Director
Phone
(972) 869-3789

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

712 N Beeline Hwy
Payson, AZ 85541-3706

Mailing address

712 N Beeline Hwy
Payson, AZ 85541-3706

Other names 1

  • Anderson Dental Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Anderson Dental Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629936000000",
    "number": "1205503299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 N BEELINE HWY",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855413706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 N BEELINE HWY",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855413706",
            "telephone_number": "928-474-4581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH BEELINE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-26",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-05",
        "status": "A",
        "authorized_official_last_name": "GASKINS",
        "authorized_official_first_name": "FAITH",
        "authorized_official_title_or_position": "CREDENTIALING DIRECTOR",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anderson Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Payson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.