William Jay Bellamy, D.D.S.
Individual provider Active NPI General Practice Dentistry · Duluth, MN
NPI 1720130735 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720130735
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- D9789 (MN)
- Practice address
- 1324 E 1St St
Duluth, MN 55805-2403 - Phone
- (218) 724-1332
- Fax
- (218) 724-2184
- NPI assigned
- Jan 18, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- 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 |
|---|---|---|---|---|
| I20160210002613 | MN | Order and Referring Only - Dentist |
3577867696 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D9789 | MN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chester Creek Dental LLC | General Practice | Past | Accepting new patients |
| William J & Kathleen E Bellamy PTR | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D9789 | MN | Yes |
Addresses
Primary practice location
1324 E 1St St
Duluth, MN 55805-2403
Mailing address
1324 E 1St St
Duluth, MN 55805-2403
Phone (218) 724-1332
Other providers in Duluth, MN
- Julie Lynn Belden
- Meaghan Marie Bell
- Daniel Bellamy
- Emily Bellamy
- Kathleen Elizabeth Bellamy
- Gerald J Bellehumeur
- Courtney Bellmore
- Belongings, LLC
- Bridget Mary Bemis
- Ricci Lee Bender
All providers in Duluth, MN · General Practice Dentistry in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.