NPIMap

Organization Active NPI

Ken a Beckerman DDS LLC

  • Dentist
  • Princeton, IN
National Provider Identifier
1679932685
Registry record updated Feb 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
KEN A BECKERMAN DDS LLC
Practice address
109 W Broadway St
Princeton, IN 47670-1501
Phone
(812) 385-2750
NPI assigned
Feb 18, 2016
Last updated
Feb 18, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ken A Beckerman, DDSNPI 1437299989
Title
Owner
Phone
(812) 385-2750

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

109 W Broadway St
Princeton, IN 47670-1501

Mailing address

304 Logan Ave
Hazleton, IN 47640-8820
Phone (812) 385-2750

National Provider Directory

National Provider Directory

Locations

109 W Broadway St
Princeton, IN 47670
Phone (812) 385-2750

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1455753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455753600000",
    "number": "1679932685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 LOGAN AVE",
            "city": "HAZLETON",
            "state": "IN",
            "postal_code": "476408820",
            "telephone_number": "812-385-2750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 W BROADWAY ST",
            "city": "PRINCETON",
            "state": "IN",
            "postal_code": "476701501",
            "telephone_number": "812-385-2750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEN A BECKERMAN DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-18",
        "last_updated": "2016-02-18",
        "status": "A",
        "authorized_official_last_name": "BECKERMAN",
        "authorized_official_first_name": "KEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-385-2750",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2016; 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.