Thomas J Bevelock, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 12865 Issued in FL

Practice address

10940 E State Road 70
Suite 102
Bradenton, FL 34202-8400

Phone

(941) 756-9604

Fax

(941) 756-0616

NPI assigned

Jan 15, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Enrolled in FL

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

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649321852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10940 E STATE ROAD 70",
            "address_2": "SUITE 102",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342028400",
            "telephone_number": "941-756-9604",
            "fax_number": "941-756-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10940 E STATE ROAD 70",
            "address_2": "SUITE 102",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342028400",
            "telephone_number": "941-756-9604",
            "fax_number": "941-756-0616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEVELOCK",
        "first_name": "THOMAS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 12865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEIN",
            "identifier": "65-0554804",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen M Bethune, ARNP
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• Teresa Sue Betts Cobau, CNP, CNM
• Kelly M Beukema
• Johanna Lee Beville, BA
• Beyond 2020 Vision Specialists Bradenton
• Maria Virginia Bezares Oliveras, M.D., MHA
• Anjuli Bhadurihauck, DO
• Ishpaul Bhamber, DO

• General Practice Dentistry in Bradenton, FL
• Providers in Bradenton, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.