BDD of Indiana P.C.

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

BDD OF INDIANA P.C.

Practice address

639 Eastern Blvd
Clarksville, IN 47129-2460

Phone

(812) 282-1773

Fax

(812) 282-1791

NPI assigned

Aug 16, 2021

Organization subpart

Yes

Parent organization

BDD OF INDIANA P.C.As reported in NPPES

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

Authorized official

Name

Jay Jorbin

Title

Cfo

Phone

(312) 805-8590

Specialties & licenses 1

Addresses

Other names 1

• Beechwood Dental Center Doing business as

Tax ID family

BDD of Indiana PC5 organizations share this tax ID, including this one

Part of

BDD of Indiana PC

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• BDD of Indiana P.C.

  • General Practice Dentistry
  • Fort Wayne, IN
  • NPI 1366117889
  NPD tax ID
• BDD of Indiana P.C.

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1457026981
  NPD tax ID
• BDD of Indiana P.C.

  • Dentist
  • Saint John, IN
  • NPI 1538834064
  NPD tax ID
• BDD of Indiana, P.C.

  • General Practice Dentistry
  • Fort Wayne, IN
  • NPI 1245015031
  NPD tax ID

Locations

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776556800000",
    "number": "1780359299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 W 1ST ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262641",
            "telephone_number": "312-805-8590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 EASTERN BLVD",
            "city": "CLARKSVILLE",
            "state": "IN",
            "postal_code": "471292460",
            "telephone_number": "812-282-1773",
            "fax_number": "812-282-1791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BDD OF INDIANA P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BDD OF INDIANA P.C.",
        "enumeration_date": "2021-08-16",
        "last_updated": "2026-04-19",
        "certification_date": "2026-04-19",
        "status": "A",
        "authorized_official_last_name": "JORBIN",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "312-805-8590"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beechwood Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Julia Barger
• Alyson Barnes, RBT
• Matthew T Basa IV, PT
• Courtney Bates, OTR/L
• Destiny Batliner, RBT
• Samantha Michelle Bearden, APRN
• Beechwood Dental Center, PC
• Denise A Benavidez, MPT
• Breanna Beswick, RN
• Demi Marie Betz, OTR

• Dentist in Clarksville, IN
• Providers in Clarksville, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2026; 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.