Brody Beck, DMD
Individual provider Active NPI General Practice Dentistry · Nampa, ID
NPI 1235625237 · NPPES record last updated Jun 28, 2021
Key facts
- NPI
- 1235625237
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- D-5289 (ID)
- Practice address
- 207 1St St S
Nampa, ID 83651-3703 - Phone
- (208) 446-6786
- Fax
- (208) 466-5359
- NPI assigned
- Jul 3, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210811000613 | ID | Order and Referring Only - Dentist |
6406250521 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health Clinics, Inc. | General Practice | Past | Accepting new patients |
| Longview Family Dental | General Practice | Past | Accepting new patients |
| Community Health Clinics, Inc. | General Practice | Past | Accepting new patients |
| Community Health Clinics, Inc. | General Practice | Past | Accepting new patients |
| Community Health Clinics, Inc. | General Practice | Past | Accepting new patients |
| Community Health Clinics, Inc. | General Practice | Past | Accepting new patients |
| Community Health Clinics, Inc. | General Practice | Past | Accepting new patients |
| Arizona Dental Professionals, PC | General Practice | Past | Accepting new patients |
| Community Health Clinics, Inc. | General Practice | Past | Accepting new patients |
| Community Health Clinics, Inc. | General Practice | Past | Accepting new patients |
| Community Health Clinics, Inc. | General Practice | Past | Accepting new patients |
Interoperability endpoints
- bbeck351155@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D-5289 | ID | Yes |
Addresses
Primary practice location
207 1St St S
Nampa, ID 83651-3703
Mailing address
PO Box 9
Nampa, ID 83653-0009
Phone (208) 467-4431
Other providers in Nampa, ID
- Allison Beaman
- Bear Home Health
- Hollie Bearce
- Madison Beatty
- Blake B Bechtle
- Matthew Brandon Beck
- Leah Beech
- Louie Ward Beech
- Doug Beeson
- Stacy Beeson
All providers in Nampa, ID · General Practice Dentistry in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.