Active NPI
Robert Nelson Beville III, DDS
- Pediatric Dentistry
- Benbrook, TX
National Provider Identifier
1215199955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 23986
- Practice address
- 4200 Bryant Irvin Rd Ste 129
Benbrook, TX 76109-4212 - Phone
- (817) 569-6633
- Fax
- (817) 569-6636
- NPI assigned
- Jun 25, 2008
- Last updated
- Oct 16, 2012
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 23986 | TX | Primary |
Addresses
Primary practice location
4200 Bryant Irvin Rd Ste 129
Benbrook, TX 76109-4212
Mailing address
2608 Museum Way Apt 3513
Fort Worth, TX 76107-3085
Phone (806) 683-3382
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 193876301 | Medicaid | TX |
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 |
|---|---|---|---|
| 23986 | TX | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beville Dentistry PC | Pediatric Dentistry | Current | Accepting new patients |
Interoperability endpoints
- rbeville33210@cookchildrens.direct-ci.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350345600000",
"number": "1215199955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2608 MUSEUM WAY APT 3513",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761073085",
"telephone_number": "806-683-3382",
"fax_number": "817-569-6636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4200 BRYANT IRVIN RD STE 129",
"city": "BENBROOK",
"state": "TX",
"postal_code": "761094212",
"telephone_number": "817-569-6633",
"fax_number": "817-569-6636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEVILLE",
"first_name": "ROBERT",
"middle_name": "NELSON",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-25",
"last_updated": "2012-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TX",
"license": "23986",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "193876301",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Benbrook, TX
- Benbrook Senior Care, LLC (Benbrook Nursing and Rehabilitation Center)
- Benbrook Smiles PLLC
- Benbrook SNF LLC (Benbrook Nursing & Rehabilitation Center)
- Robert F Benningfield, DDS
- Steven Paul Bergman, L.A.T.
- Brooke Alese Beyrooty, DPT
- Dustin Lee Blevins
- Bob Lanier MD PA
- Grace Morgan Booth, BCBA, LBA
- Tanya Borrego
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.