Active NPI
Neil Michael Bealka III, D.D.S.
- Dentist
- Sugar Land, TX
National Provider Identifier
1790190908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30055
- Practice address
- 4724 Sweetwater Blvd Ste 101
Sugar Land, TX 77479-3150 - Phone
- (281) 491-5655
- NPI assigned
- Jun 25, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 30055 | TX | |
| Dentist | 122300000X | 30055 | TX | Primary |
Addresses
Primary practice location
4724 Sweetwater Blvd Ste 101
Sugar Land, TX 77479-3150
Mailing address
13008 Bent Oak Dr
Waco, TX 76712-8536
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30055 | TX | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685664000000",
"number": "1790190908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13008 BENT OAK DR",
"city": "WACO",
"state": "TX",
"postal_code": "767128536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4724 SWEETWATER BLVD STE 101",
"city": "SUGAR LAND",
"state": "TX",
"postal_code": "774793150",
"telephone_number": "281-491-5655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEALKA",
"first_name": "NEIL",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-25",
"last_updated": "2023-06-02",
"certification_date": "2021-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "TX",
"license": "30055",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "30055",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sugar Land, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.