Beavers and Broomfield Family Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3600 Issued in AR

Legal business name

BEAVERS AND BROOMFIELD FAMILY DENTISTRY

Practice address

2131 N Crossover Rd
Suite101
Fayetteville, AR 72703-4333

Phone

(479) 856-6610

NPI assigned

Aug 28, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Kristen Beavers, DDS

Title

Owner

Phone

(479) 856-6610

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219881600000",
    "number": "1881842136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2131 N CROSSOVER RD",
            "address_2": "SUITE101",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 N CROSSOVER RD",
            "address_2": "SUITE101",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034333",
            "telephone_number": "479-856-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAVERS AND BROOMFIELD FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-28",
        "last_updated": "2008-08-28",
        "status": "A",
        "authorized_official_last_name": "BEAVERS",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-856-6610",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168653631",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Jade Beasley
• Kelly Kathleen Beaton
• Rebecca Beauchamp, D.D.S.
• Adriana Beaudoin
• Laura Ann Beaufford, APRN-CNP, PMHNP-BC
• Zach Beavers, L.AC.
• Brian Bechtold
• Teresa Gayle Beck-Fuller, M.S.,CCC-SLP
• Rachel Ricca Beck, MS, CCC-SLP
• Raven Jewel Beck

• General Practice Dentistry in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.