Individual provider Active NPI

Beverly N Cruthirds Callaway, DDS

  • Dentist
  • National City, CA
National Provider Identifier
1396174439
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019029680 Issued in IL
Practice address
2835 Highland Ave
National City, CA 91950-7404
Phone
(844) 200-2426
Fax
(619) 474-4008
NPI assigned
Nov 8, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019029680 IL Primary
Dentist 122300000X 7184-15 WI

Addresses

Primary practice location

2835 Highland Ave
National City, CA 91950-7404

Mailing address

637 3Rd Ave Ste E1
Chula Vista, CA 91910-5707
Phone (844) 200-2426

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7184-15WIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1396174439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 3RD AVE STE E1",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919105707",
            "telephone_number": "844-200-2426",
            "fax_number": "619-356-2726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 HIGHLAND AVE",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919507404",
            "telephone_number": "844-200-2426",
            "fax_number": "619-474-4008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUTHIRDS CALLAWAY",
        "first_name": "BEVERLY",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-08",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019029680",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "7184-15",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in National City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.