Individual provider Active NPI

Michael Thomas Beckham, D.D.S

  • General Practice Dentistry
  • Cave Creek, AZ
National Provider Identifier
1790989135
Registry record updated Mar 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2763 Issued in AZ
Practice address
4815 E Carefree Hwy Ste 102
Cave Creek, AZ 85331-4718
Phone
(480) 214-9060
Fax
(480) 339-0079
NPI assigned
Jun 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2763 AZ Primary

Addresses

Primary practice location

4815 E Carefree Hwy Ste 102
Cave Creek, AZ 85331-4718

Mailing address

4815 E Carefree Hwy Ste 102
Cave Creek, AZ 85331-4718
Phone (480) 214-9060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160328002303 AZ Order and Referring Only - DentistPractitioner - Dentist 7416861018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Michael Beckham DDS PC General Practice PastSince Dec 1, 2008 Accepting new patients
Avondale Urgent Care LLC PastSince Nov 12, 2002 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457395200000",
    "number": "1790989135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4815 E CAREFREE HWY STE 102",
            "city": "CAVE CREEK",
            "state": "AZ",
            "postal_code": "853314718",
            "telephone_number": "480-214-9060",
            "fax_number": "480-339-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 E CAREFREE HWY STE 102",
            "city": "CAVE CREEK",
            "state": "AZ",
            "postal_code": "853314718",
            "telephone_number": "480-214-9060",
            "fax_number": "480-339-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKHAM",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-11",
        "last_updated": "2016-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "2763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cave Creek, AZ

Sources for this page

Verify at the official NPI Registry.