Clem Kip Beals III, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30.014820 Issued in OH

Practice address

396 E Church St
Marion, OH 43302-4106

Phone

(740) 387-4355

Fax

(740) 375-5540

NPI assigned

Jan 15, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437200664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "396 E CHURCH ST",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433024106",
            "telephone_number": "740-387-4355",
            "fax_number": "740-375-5540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 E CHURCH ST",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433024106",
            "telephone_number": "740-387-4355",
            "fax_number": "740-375-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEALS",
        "first_name": "CLEM",
        "middle_name": "KIP",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.014820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Woodrow P Barry, P.A.
• Lauran Bauer, CNP
• Alyson Baughman
• Leslee Baxter
• James Bazzoli, MD
• Sunshine Sylinda Bean, LSD
• Andrea Jo Beardsley, NP
• Leslie Jane Beary, MSW, LISW
• Kylene Beck, RD,LD
• Richard Todd Beckman, D.D.S.

• General Practice Dentistry in Marion, OH
• Providers in Marion, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.