Active NPI
Marielle Youmans Beauchamp, DMD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Port Orange, FL
National Provider Identifier
1447611629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DN24005
- Practice address
- 3890 Turtle Creek Dr Ste a
Port Orange, FL 32127-9352 - Phone
- (229) 254-2098
- NPI assigned
- Mar 15, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DN24005 | FL | Primary |
Addresses
Primary practice location
3890 Turtle Creek Dr Ste a
Port Orange, FL 32127-9352
Mailing address
3890 Turtle Creek Dr Ste a
Port Orange, FL 32127-9352
Phone (229) 254-2098
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN24005 | FL | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728345600000",
"number": "1447611629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3890 TURTLE CREEK DR STE A",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321279352",
"telephone_number": "229-254-2098"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3890 TURTLE CREEK DR STE A",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321279352",
"telephone_number": "229-254-2098"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAUCHAMP",
"first_name": "MARIELLE",
"middle_name": "YOUMANS",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-15",
"last_updated": "2024-10-08",
"certification_date": "2024-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "FL",
"license": "DN24005",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Orange, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.