Gregg W. Beaty, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

034467 Issued in CA

Practice address

3737 Moraga Ave
Suite B-200
San Diego, CA 92117-5404

Phone

(858) 272-7086

Fax

(858) 272-7289

NPI assigned

Nov 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780755959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 MORAGA AVE",
            "address_2": "SUITE B-200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921175404",
            "telephone_number": "858-272-7086",
            "fax_number": "858-272-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 MORAGA AVE",
            "address_2": "SUITE B-200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921175404",
            "telephone_number": "858-272-7086",
            "fax_number": "858-272-7289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEATY",
        "first_name": "GREGG",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "034467",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WI",
            "license": "4036-015",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan J Beattie, PHD
• Beatty Chiropractic, Inc.
• Michael Beatty, PTA
• Parker Beatty, DO
• Zach Beatty, D.C
• Henry Joshua Sterling Beaty, IDC L10A
• Rachel Beaubier, RN, PHN, IBCLC
• Julia Beauchamp-Walters, M.D.
• Monique Beauchamp, MFT
• Sandra Saritha Beauchamp, MD, MPHTM

• Oral and Maxillofacial Surgery (Dentist) in San Diego, CA
• Providers in San Diego, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.