Jeffrey L Beattie, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN11558 Issued in FL

Practice address

1573 W Fairbanks Ave
Suite 300
Winter Park, FL 32789-4679

Phone

(407) 644-0224

Fax

(407) 644-2827

NPI assigned

Oct 18, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Oral & Maxillofacial Surgeons of Mid-Florida, PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Orlando, FL
  • NPI 1700053881
  NPD (past) Authorized official

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263340800000",
    "number": "1811986243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1573 W FAIRBANKS AVE",
            "address_2": "SUITE 300",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894679",
            "telephone_number": "407-644-0224",
            "fax_number": "407-644-2827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1573 W FAIRBANKS AVE",
            "address_2": "SUITE 300",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894679",
            "telephone_number": "407-644-0224",
            "fax_number": "407-644-2827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEATTIE",
        "first_name": "JEFFREY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2010-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN11558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCARE ORL OFC",
            "identifier": "190007446",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE ORLANDO OFC",
            "identifier": "224946",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCARE LW OFC",
            "identifier": "850000180",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "69148",
            "identifier": "BCBS MEDICAL",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE WINTER PARK OFC",
            "identifier": "06818",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCARE WP OFC",
            "identifier": "190007440",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE LONGWOOD OFC",
            "identifier": "224944",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beach Medical X3 LLC
• Andrew Ray Beachum, D.C.
• Ashley Bean
• Joslyn O'Connor Bear, ARNP
• Gabrielle Grace Beasley, COTA
• Virginia Beaufort, MS
• Colleen Renee Bechtel, PHARMD
• Arianna Eva Becker, DO
• Vallerie Becker
• Beckham Counseling LLC

• Oral and Maxillofacial Surgery (Dentist) in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2010; 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.