Clay Allen Beshore, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6588 Issued in KS

Practice address

4621 W 6TH St Ste B
Lawrence, KS 66049-4358

Phone

(785) 856-8550

NPI assigned

Nov 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Mountain Smiles - Heck Family Dentistry PLLC

  • Dental Clinic/Center
  • Lawrence, KS
  • NPI 1366304966
  NPD (past)
• Rem Anesthesia, LLC

  • Certified Registered Nurse Anesthetist
  • Shawnee, KS
  • NPI 1417609405
  NPD (past)
• The Dental Retreat at Mountain Park

  • Dental Clinic/Center
  • Travelers Rest, SC
  • NPI 1821485640
  NPD (past)

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1508848466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4621 W 6TH ST STE B",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660494358",
            "telephone_number": "785-856-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4621 W 6TH ST STE B",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660494358",
            "telephone_number": "785-856-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BESHORE",
        "first_name": "CLAY",
        "middle_name": "ALLEN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "6588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL OF KANSAS PR",
            "identifier": "481217182",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF KANSAS PROVIDER",
            "identifier": "116585",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200306700A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bert Nash Community Mental Health Center
• Bert Nash Community Mental Health Center Inc
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• Bert Nash Community Mental Health Center Inc
• Brecken Spencer Bertie
• Natalie Bethel
• Betsy the Doula, LLC
• Better Day Psychological Services, LLC
• Amy Michelle Beutler, R.D.
• Kastoor Bhana, LP PHD

• General Practice Dentistry in Lawrence, KS
• Providers in Lawrence, KS by specialty
• General Practice Dentistry in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.