Tyrel Timothy Beavers, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4798 Issued in AZ

Practice address

1259 N. Power Rd #2
Mesa, AZ 85205

Phone

(480) 832-4567

Fax

(480) 854-3869

NPI assigned

Sep 28, 2006

Last updated

Jun 23, 2015By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Picasso Dental Az

  • General Practice Dentistry
  • Mesa, AZ
  • NPI 1326110024
  NPD (past)

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435017600000",
    "number": "1679665871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1259 N. POWER RD #2",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85205",
            "telephone_number": "480-832-4567",
            "fax_number": "480-854-3869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1259 N. POWER RD #2",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85205",
            "telephone_number": "480-832-4567",
            "fax_number": "480-854-3869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAVERS",
        "first_name": "TYREL",
        "middle_name": "TIMOTHY",
        "name_prefix": "Mr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2015-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "4798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Euvada Shernaye Beaton, MA, LAC
• Dawn R Beatty-Taylor, MC, LPC, CTNC
• Colleen Ladina Irene Beaufils, APRN, FNP-C
• Leah Beauton
• Heather Jo Beauvais, SLPA
• Jose Becerrilarcos
• Kaylee Becher, RN
• Lance Lee Bechtold, MD
• Geoffrey E Beck, MD
• Keiko Katherine Beck, FNP-C

• General Practice Dentistry in Mesa, AZ
• Providers in Mesa, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2015; 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.