NPIMap

Organization Active NPI

Childrens Dentistry of Beaumont, P.C.

  • Periodontics
  • Beaumont, TX
National Provider Identifier
1861644601
Registry record updated Oct 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
20249 Issued in TX
Legal business name
CHILDRENS DENTISTRY OF BEAUMONT, P.C.
Practice address
6755 Phelan Blvd.
Suite 32
Beaumont, TX 77706
Phone
(409) 866-8886
NPI assigned
Oct 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2008

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

Authorized official

Name
Dr. Lee Ann McQuade, DDSNPI 1518016534
Title
Owner/Pediatric Dentist
Phone
(409) 866-8886

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 20249 TX Primary

Addresses

Primary practice location

6755 Phelan Blvd.
Suite 32
Beaumont, TX 77706

Mailing address

2435 FM 1406 Rd.
Winnie, TX 77665
Phone (409) 866-8886

National Provider Directory

National Provider Directory

Locations

6755 Phelan Blvd
Ste 32
Beaumont, TX 77706
Phone (409) 866-8886

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1223596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223596800000",
    "number": "1861644601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2435 FM 1406 RD.",
            "city": "WINNIE",
            "state": "TX",
            "postal_code": "77665",
            "telephone_number": "409-866-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6755 PHELAN BLVD.",
            "address_2": "SUITE 32",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "77706",
            "telephone_number": "409-866-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRENS DENTISTRY OF BEAUMONT, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-10",
        "last_updated": "2008-10-10",
        "status": "A",
        "authorized_official_last_name": "MCQUADE",
        "authorized_official_first_name": "LEE ANN",
        "authorized_official_title_or_position": "OWNER/PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "409-866-8886",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "20249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2008; 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.