Kent A Beesley, DDS
Individual provider Active NPI General Practice Dentistry · Saint Anthony, ID
NPI 1679738397 · NPPES record last updated May 28, 2025
Key facts
- NPI
- 1679738397
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- D-4174 (ID)
- Practice address
- 325 E Main St
Saint Anthony, ID 83445 - Phone
- (208) 356-4900
- Fax
- (208) 624-4117
- NPI assigned
- Jul 22, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160622000972 | ID | Order and Referring Only - Oral Surgery |
2769773738 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Upper Valley Community Health Services Inc | Past |
Accepting new patients | |
| Upper Valley Community Health Services Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D-4174 | ID | Yes |
Addresses
Primary practice location
325 E Main St
Saint Anthony, ID 83445
Mailing address
PO Box 18
Saint Anthony, ID 83445-0018
Phone (208) 356-4900
Other practice location 1
72 S 1st E Ste 102
Rexburg, ID 83440-1965
Phone (208) 356-4900
Other providers in Saint Anthony, ID
- Allen Pharmacy Service
- Allen Pharmacy Services Inc
- Arcadia Mental Health Resources
- Sydni Arnold
- Back Country Chiropractic PLLC
- Erin Joanne Benson
- Larry Miles Bradley
- Gabel C Brizzee
- Broulim Supermarkets, LLC
- Andrew Logan Brower
All providers in Saint Anthony, ID · General Practice Dentistry in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 28, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.