Beaumont Dental Group

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

64330 Issued in CA

Legal business name

BEAUMONT DENTAL GROUP

Practice address

930 Beaumont Ave
Beaumont, CA 92223-1831

Phone

(951) 845-2200

NPI assigned

Mar 22, 2015

Last updated

Mar 22, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Anu Duckworth, DDS

Title

Owner

Phone

(909) 528-8556

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anu Chachad, DDS

  • General Practice Dentistry
  • Beaumont, CA
  • NPI 1225180235
  NPD (past)

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

{
    "created_epoch": "1426982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426982400000",
    "number": "1457745002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 BEAUMONT AVE",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922231831",
            "telephone_number": "951-845-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 BEAUMONT AVE",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922231831",
            "telephone_number": "951-845-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUMONT DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-22",
        "last_updated": "2015-03-22",
        "status": "A",
        "authorized_official_last_name": "DUCKWORTH",
        "authorized_official_first_name": "ANU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-528-8556",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "64330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariah Michelle Barsi
• Omar J Bashir, D.O.
• Melissa Linda Bautista, LPCC
• Angela Beal
• Beaumont Chiropractic
• Beaumont Manor LLC (Highland Springs Care Center)
• Beaumont Radiology Services LLC (Highland Springs Imaging Center)
• Beaumont SNF Healthcare, LLC (Vista Real Post Acute)
• Beaumont Unified School District (Beaumont USD)
• Beaver Medical Group LP (Beaver Medical Group Highland Springs)

• General Practice Dentistry in Beaumont, CA
• Providers in Beaumont, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.