Dudley C. Beaty III, DMD, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DUDLEY C. BEATY III, DMD, PC

Practice address

225 Broad St
Bennettsville, SC 29512-4003

Phone

(843) 479-0305

NPI assigned

Jan 12, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Dudley C. Beaty III, DMDNPI 1003894478

Title

Owner

Phone

(843) 479-0305

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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

• Dudley C. Beaty III, DMD

  • General Practice Dentistry
  • Bennettsville, SC
  • NPI 1003894478
  NPD (past) Authorized official

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376693937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 BROAD ST",
            "city": "BENNETTSVILLE",
            "state": "SC",
            "postal_code": "295124003",
            "telephone_number": "843-479-0305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 BROAD ST",
            "city": "BENNETTSVILLE",
            "state": "SC",
            "postal_code": "295124003",
            "telephone_number": "843-479-0305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUDLEY C. BEATY III, DMD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BEATY",
        "authorized_official_first_name": "DUDLEY",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-479-0305",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL PROVIDER #",
            "identifier": "2906",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9903",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alton Davis
• Lisa Josephine Destefano, MA
• Maelene Dobson, MS,LCAS
• Anna Dowd
• Glenn Dowdy, RPH
• Dundee Manor, LLC
• Thomas Patrick Dunne, M.D.
• Jana Ebbert, D.O.
• Edwards Chiropractic Wellness Center, P.a.
• Emotions 4Life

• General Practice Dentistry in Bennettsville, SC
• Providers in Bennettsville, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.