Amanda Beamon

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

14710 Issued in CT

Practice address

1141 Wolcott St
Waterbury, CT 06705-1318

Phone

(475) 559-7908

NPI assigned

Mar 15, 2024

Last updated

Sep 22, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1710460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1306605993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 WOLCOTT ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067051318",
            "telephone_number": "475-559-7908",
            "fax_number": "475-559-7941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 WOLCOTT ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067051318",
            "telephone_number": "475-559-7908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Park St Ste C",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061062232",
            "country_code": "US",
            "telephone_number": "860-519-1917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEAMON",
        "first_name": "AMANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-15",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CT",
            "license": "14710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Esther Shalva Baylis, LCSW
• Lynn Baylis, P.A.
• Tetiana Kihiczak Bazarko, DPM
• Shawn Bazemore
• Joyce Lawton Bea, RPT
• Shomari Beamon, LPC
• Jodie Beauchamp
• Kency Beauliere
• Beautiful Age Home Care LLC
• Paul J Beauvais, MD

• Pediatric Dentistry in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Pediatric Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; 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.