Individual provider Active NPI

Barrett Nash Beardsley, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • San Antonio, TX
National Provider Identifier
1851609713
Registry record updated Jul 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
36986 Issued in TX
Practice address
525 Oak Centre Dr Ste 210
San Antonio, TX 78258-3916
Phone
(210) 762-4982
NPI assigned
Sep 14, 2010
Last updated
Jul 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7726693-9921 UT
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 36986 TX Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 7726693-9921 UT

Addresses

Primary practice location

525 Oak Centre Dr Ste 210
San Antonio, TX 78258-3916

Mailing address

19 Champions Run
San Antonio, TX 78258-7720
Phone (714) 280-6763

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

LicenseStateTypeSpecialty
7726693-9921UTMDGeneral Practice Dentistry
36986TXMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688774400000",
    "number": "1851609713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 CHAMPIONS RUN",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782587720",
            "telephone_number": "714-280-6763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 OAK CENTRE DR STE 210",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583916",
            "telephone_number": "210-762-4982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEARDSLEY",
        "first_name": "BARRETT",
        "middle_name": "NASH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-14",
        "last_updated": "2023-07-08",
        "certification_date": "2023-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "7726693-9921",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "36986",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "7726693-9921",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

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

Verify at the official NPI Registry.