NPIMap

Organization Active NPI

Beaumont Dental PLLC

  • General Practice Dentistry
  • Beaumont, TX
National Provider Identifier
1437533684
Registry record updated Jul 17, 2015
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
23695 Issued in TX
Legal business name
BEAUMONT DENTAL PLLC
Practice address
4400 Highland Ave
Beaumont, TX 77705-5205
Phone
(409) 813-1702
NPI assigned
Jul 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2015

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

Authorized official

Name
Dr. Everett C Evans, DDS
Title
Owner, DDS
Phone
(940) 808-1970

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 23695 TX Primary

Addresses

Primary practice location

4400 Highland Ave
Beaumont, TX 77705-5205

Mailing address

PO Box 674330
Dallas, TX 75267-4330
Phone (940) 808-1970

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437091200000",
    "number": "1437533684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 674330",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752674330",
            "telephone_number": "940-808-1970",
            "fax_number": "855-731-5147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 HIGHLAND AVE",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777055205",
            "telephone_number": "409-813-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUMONT DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-17",
        "last_updated": "2015-07-17",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "EVERETT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER, DDS",
        "authorized_official_telephone_number": "940-808-1970",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; 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.