Virginia Beazley
Individual provider Active NPI Dentist · Goodlettsville, TN
NPI 1487020012 · NPPES record last updated Aug 18, 2015
Key facts
- NPI
- 1487020012
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 10145 (TN)
- Practice address
- 318 Northcreek Blvd
Suite 400
Goodlettsville, TN 37072-1934 - Phone
- (615) 239-4000
- NPI assigned
- Aug 18, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10145 | TN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northcreek Dental | Past | Accepting new patients | |
| Rudolph Dean Lang, PLLC | Dentist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 10145 | TN | Yes |
| General Practice Dentistry | 1223G0001X | 10145 | TN |
Addresses
Primary practice location
318 Northcreek Blvd
Suite 400
Goodlettsville, TN 37072-1934
Mailing address
318 Northcreek Blvd
Suite 400
Goodlettsville, TN 37072-1934
Other providers in Goodlettsville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.