Bellefontaine Dental, Mark R. Bedford, DDS, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

15902 Issued in OH

Legal business name

BELLEFONTAINE DENTAL, MARK R. BEDFORD, DDS, LLC

Practice address

4 W Main St
Suite 908
Springfield, OH 45502-1300

Phone

(937) 322-7832

Fax

(937) 322-7946

NPI assigned

Jun 6, 2011

Organization subpart

No

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

Authorized official

Name

Kathy S Nelson

Title

Practice Manager

Phone

(937) 206-4080

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sarah Elizabeth Ash, D.D.S.

  • Dentist
  • Bellefontaine, OH
  • NPI 1770929325
  NPD (past)
• Kevin Grill, DDS

  • Dentist
  • Marion, OH
  • NPI 1548616592
  NPD (past)
• Frederick Joseph Krock, DDS

  • General Practice Dentistry
  • Bellefontaine, OH
  • NPI 1851454458
  NPD (past)

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307318400000",
    "number": "1720372899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 W CHILLICOTHE AVE",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433111472",
            "telephone_number": "937-592-1776",
            "fax_number": "937-592-4566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 W MAIN ST",
            "address_2": "SUITE 908",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455021300",
            "telephone_number": "937-322-7832",
            "fax_number": "937-322-7946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLEFONTAINE DENTAL, MARK R. BEDFORD, DDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-06",
        "last_updated": "2011-06-06",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "937-206-4080"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OH",
            "license": "15902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tala Adnan Belbeissi, MD
• Lindsey Belcher, FNP-C
• Marley Bell
• Jowana Marie Belle
• Shayvokiea Belle
• Tracy Bellville
• Sonya Belt
• Tiffany Benfield, BCBA
• Abigail Benjamin
• Andrew Benner

• Dentist in Springfield, OH
• Providers in Springfield, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; 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.