NPIMap

Organization Active NPI

John Beack DMD PS

  • Dental Clinic/Center
  • Kent, WA
National Provider Identifier
1295083632
Registry record updated Aug 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DE00010948 Issued in WA
Legal business name
JOHN BEACK DMD PS
Practice address
13210 SE 240TH St
Suite B1
Kent, WA 98042-5182
Phone
(253) 631-8490
NPI assigned
Aug 15, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2012

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

Authorized official

Name
John BeackNPI 1134205842
Title
President
Phone
(425) 999-2402

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DE00010948 WA Primary

Addresses

Primary practice location

13210 SE 240TH St
Suite B1
Kent, WA 98042-5182

Mailing address

13210 SE 240TH St
Suite B1
Kent, WA 98042-5182
Phone (253) 631-8490

National Provider Directory

National Provider Directory

Locations

13210 SE 240th St
Ste B1
Kent, WA 98042
Phone (253) 631-8490

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344988800000",
    "number": "1295083632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13210 SE 240TH ST",
            "address_2": "SUITE B1",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980425182",
            "telephone_number": "253-631-8490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13210 SE 240TH ST",
            "address_2": "SUITE B1",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980425182",
            "telephone_number": "253-631-8490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN BEACK DMD PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-15",
        "last_updated": "2012-08-15",
        "status": "A",
        "authorized_official_last_name": "BEACK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-999-2402"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "DE00010948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.

Verify at the official NPI Registry.