Ken A. Beckerman, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12007838 Issued in IN

Practice address

109 W Broadway St
Princeton, IN 47670-1501

Phone

(812) 385-2750

Fax

(812) 385-2878

NPI assigned

Feb 7, 2007

Last updated

Jan 24, 2017By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ken a Beckerman DDS LLC

  • Dentist
  • Princeton, IN
  • NPI 1679932685
  Authorized official Same address or phone

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1437299989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 W BROADWAY ST",
            "address_2": "PO BOX 462",
            "city": "PRINCETON",
            "state": "IN",
            "postal_code": "476701501",
            "telephone_number": "812-385-2750",
            "fax_number": "812-385-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 W BROADWAY ST",
            "city": "PRINCETON",
            "state": "IN",
            "postal_code": "476701501",
            "telephone_number": "812-385-2750",
            "fax_number": "812-385-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKERMAN",
        "first_name": "KEN",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12007838",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12007838",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1437299989",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Back2Health-Princeton, LLC
• Makayla M Bailey
• Sandra Ann Barrett, R.PH
• Trent Barrett
• Jamie Bartlett, MSN, APRN, FNP, CCRN
• Sharon S Beckerman, RN
• April Benjamin, MSN,RN
• Patti Binder, MD
• Christina K Binhack
• Pam Bishop

• Dentist in Princeton, IN
• Providers in Princeton, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2017; 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.