Shannel Beckles, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

22DI02730800 Issued in NJ

Practice address

15 Freeman Ave
East Orange, NJ 07018

Phone

(973) 813-7263

NPI assigned

Dec 3, 2018

Last updated

Jun 30, 2019By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1543795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561852800000",
    "number": "1679043624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 GRIER AVE APT A3",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072023354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 FREEMAN AVE",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "07018",
            "telephone_number": "973-813-7263"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Ferry St Ste B",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071051438",
            "country_code": "US",
            "telephone_number": "973-589-5900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2047 E 53rd Pl",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112344710",
            "country_code": "US",
            "telephone_number": "718-808-3586",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BECKLES",
        "first_name": "SHANNEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-03",
        "last_updated": "2019-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02730800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna L Baumwell, MSW,LCSW
• Carolin Del Pilar Bautista, LSW
• Radhika Bawa, MD
• BB Healthcare Services Inc.
• Be Pampered Doula
• Brian Bedotto, C.P.
• Alan Lawrence Beitler, M.D.
• Latisa Bell
• Mia Bell
• Beloved Care Home Agency Services LLC

• Dentist in East Orange, NJ
• Providers in East Orange, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2019; 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.