Scott Bedichek, DDS, MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

23139 Issued in TX

Practice address

5310 North Tarrant Parkway #104
Keller, TX 76248

Phone

(817) 581-4867

Fax

(817) 581-4866

NPI assigned

Sep 28, 2006

Last updated

Aug 2, 2007By the provider in NPPES

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186012800000",
    "number": "1821180886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 N. TARRANT PARKWAY #104",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "76248",
            "telephone_number": "817-581-4867",
            "fax_number": "817-581-4866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 NORTH TARRANT PARKWAY #104",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "76248",
            "telephone_number": "817-581-4867",
            "fax_number": "817-581-4866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDICHEK",
        "first_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "23139",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OK",
            "license": "5730",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Baylor Regional Medical Center at Grapevine (Baylor Diagnostic Imaging Center - Keller)
• Bear Creek Pharmacy LLC
• Bear Creek Surgery Center, LLC
• Vickie Annette Beavers, LPC, LMFT
• Erica Michelle Bedford, M.S CCC/SLP
• Lauren Beene
• Amanda Nicole Beevers, MSN, RN, FNP-C, CEN
• David Benjamin Belman, DDS
• Brianna Bennett
• Bennettpreston Corp (Home Helpers)

• Periodontics in Keller, TX
• Providers in Keller, TX by specialty
• Periodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.