Organization Active NPI

Julie Becker, DDS, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Springfield, MO
National Provider Identifier
1689642308
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
JULIE BECKER, DDS, PC
Practice address
3820 S Fremont Ave
Springfield, MO 65804-6503
Phone
(417) 882-0948
Fax
(417) 882-7548
NPI assigned
Mar 9, 2006
Last updated
Apr 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Authorized official

Name
Melvina Tucker
Title
Office Manager
Phone
(417) 882-0948

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

3820 S Fremont Ave
Springfield, MO 65804-6503

Mailing address

3820 S Fremont Ave
Springfield, MO 65804-6503
Phone (417) 882-0948

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071029000056 MO Part B Supplier - Clinic/Group Practice 3072600790 Receives reassigned benefits from 3 practitioners
Practice locations: Springfield, MO

National Provider Directory

National Provider Directory

Locations

3820 S Fremont Ave
Springfield, MO 65804
Phone (417) 882-0948

Practitioners & affiliated clinicians

Practitioners 4

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": "1141862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649808000000",
    "number": "1689642308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 S FREMONT AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658046503",
            "telephone_number": "417-882-0948",
            "fax_number": "417-882-7548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 S FREMONT AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658046503",
            "telephone_number": "417-882-0948",
            "fax_number": "417-882-7548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIE BECKER, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-09",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "MELVINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "417-882-0948"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.