Active NPI
Chris C Beal, DDS
- Dentist
- Eagle, CO
National Provider Identifier
1225288129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 9677
- Practice address
- 1185 Capitol St Ste 104
Eagle, CO 81631-5000 - Phone
- (970) 328-5268
- Fax
- (970) 328-5267
- NPI assigned
- Sep 26, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 9677 | CO | Primary |
| Dentist | 122300000X | 54859 | CA |
Addresses
Primary practice location
1185 Capitol St Ste 104
Eagle, CO 81631-5000
Mailing address
PO Box 5499
1185 Capitol St. Suite 104
Eagle, CO 81631-5499
Phone (970) 328-5268
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972871051 | Other | CO | FACILITY NPI |
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 |
|---|---|---|---|
| 9677 | CO | MD | Dentist |
| 54859 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eagle Family Dentistry | 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.
-
- General Practice Dentistry
- Eagle, CO
- NPI 1972871051
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361836800000",
"number": "1225288129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5499",
"address_2": "1185 CAPITOL ST. SUITE 104",
"city": "EAGLE",
"state": "CO",
"postal_code": "816315499",
"telephone_number": "970-328-5268",
"fax_number": "970-328-5267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1185 CAPITOL ST STE 104",
"city": "EAGLE",
"state": "CO",
"postal_code": "816315000",
"telephone_number": "970-328-5268",
"fax_number": "970-328-5267"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAL",
"first_name": "CHRIS",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-09-26",
"last_updated": "2013-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "9677",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "54859",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FACILITY NPI",
"identifier": "1972871051",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eagle, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.