Beck Dental PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BECK DENTAL PLLC

Doing business as

Revere Dental

Practice address

588 William R Latham Sr Dr Ste 2
Bourbonnais, IL 60914-2340

Phone

(815) 933-6100

NPI assigned

Jul 22, 2025

Organization subpart

No

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

Authorized official

Name

Mark Beck, DMDNPI 1255886552

Title

Owner

Phone

(630) 805-1687

Specialties & licenses 1

Addresses

Other names 1

• Revere Dental Doing business as

Tax ID family

Beck Dental PLLC2 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.

• Beck Dental PLLC

  • General Practice Dentistry
  • Bourbonnais, IL
  • NPI 1902782154
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark J. Beck, D.M.D.

  • Dentist
  • Wheaton, IL
  • NPI 1255886552
  NPD Authorized official

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

{
    "created_epoch": "1753142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753142400000",
    "number": "1245112333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "588 WILLIAM R LATHAM SR DR STE 2",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142340",
            "telephone_number": "815-933-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "588 WILLIAM R LATHAM SR DR STE 2",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142340",
            "telephone_number": "815-933-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BECK DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-22",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A",
        "authorized_official_last_name": "BECK",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-805-1687",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revere Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Naina Batish, MD
• Sagar Batish
• Marian Baud, LCSW
• Beacon Counseling and Wellness LLC
• Ashley Beard, BCBA, LBA
• Beck Dental PLLC
• Jamie Jo Beedle, MSW
• Chelsea Diane Beers
• Jabiz Behzadpour, DO
• Emily Jacqueline Belschner

• Dental Clinic/Center in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2025; 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.