Tjark Ryan Beaven, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9915 Issued in CO

Practice address

14807 W 64TH Ave
Suite C
Arvada, CO 80007-0104

Phone

(303) 456-4095

Fax

(303) 484-2596

NPI assigned

Jun 10, 2008

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

Medicare fee-for-service enrollment

Enrolled in NY

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.

• Arvada Modern Dentistry, LLP

  dba Arvada Modern Dentistry and Orthodontics

  • General Practice Dentistry
  • Arvada, CO
  • NPI 1164661013
  NPD (past)

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306972800000",
    "number": "1558521955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13456 VIA VARRA RD",
            "address_2": "APT. #131",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800209001",
            "telephone_number": "631-949-5585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14807 W 64TH AVE",
            "address_2": "SUITE C",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800070104",
            "telephone_number": "303-456-4095",
            "fax_number": "303-484-2596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAVEN",
        "first_name": "TJARK",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-10",
        "last_updated": "2011-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "9915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Ann Beaman, N.P.
• Christopher Randal Bean
• Todd William Beatty, MD
• Danae Beaudette, CMT
• Brian Beaumund, PSYD
• Kelsey Lynn Beck
• Madeleine G Becker, MS, MA, LPC
• Melanie Beeson
• Anne Behrent, PSYD
• Melissa Behrer, PA-C

• General Practice Dentistry in Arvada, CO
• Providers in Arvada, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2011; 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.