Active NPI
Bethany Middleton, DMD, MS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Springfield, IL
National Provider Identifier
1235535808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 019029349
- Practice address
- 2534 Farragut Dr
Springfield, IL 62704-1457 - Phone
- (217) 546-4674
- NPI assigned
- Nov 10, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 019029349 | IL | Primary |
Addresses
Primary practice location
2534 Farragut Dr
Springfield, IL 62704-1457
Mailing address
2534 Farragut Dr
Springfield, IL 62704-1457
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019029349 | IL | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415577600000",
"number": "1235535808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2534 FARRAGUT DR",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627041457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2534 FARRAGUT DR",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627041457",
"telephone_number": "217-546-4674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIDDLETON",
"first_name": "BETHANY",
"credential": "DMD, MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-10",
"last_updated": "2014-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "IL",
"license": "019029349",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, IL
- Brenda L Michel, FNP-BC
- Michelle Krieger Counseling Incorporated
- Jay William Lewis Michels, D.O.
- Mid America Emergency Medicine
- Middleton Dental LLC
- John Zachary Middleton, DMD
- Midwest Clinical Counseling
- Midwest Dialectical Behavior Therapy, LLC
- Midwest Emergency Department Specialists LTD
- Midwest Eye Associates, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.