Robert W. Beavers, D.D.S.
Individual provider Active NPI General Practice Dentistry · Beebe, AR
NPI 1750397881 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1750397881
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- AR3214 (AR)
- Practice address
- 102 N Main St
Beebe, AR 72012-3046 - Phone
- (501) 882-5491
- Fax
- (501) 885-5271
- NPI assigned
- Jul 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- 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 |
|---|---|---|---|---|
| I20150311001763 | AR | Order and Referring Only - Dentist |
1759607682 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AR3214 | AR | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beebe Family Dentistry, PA | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | AR3214 | AR | Yes |
Addresses
Primary practice location
102 N Main St
Beebe, AR 72012-3046
Mailing address
102 N Main St
Beebe, AR 72012-3046
Phone (501) 882-5491
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5T649 | Other | AR | BCBS PROVIDER I.D. |
| 971125 | Other | AR | UNITEDCONCORDIA PROVIDER |
Other providers in Beebe, AR
- William James Ashburn
- Rebekah Askew
- Karissa Lynn Baggett
- Baptist Health
- Lesley Ann Barry
- Beebe Chiropractic, PA
- Beebe Drug Inc
- Beebe Drug Inc LTC
- Beebe Family Dentistry, PA
- Beebe Family Eye Care
All providers in Beebe, AR · General Practice Dentistry in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 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.