Beck Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

BECK DENTAL PLLC

Doing business as

Revere Dental

Practice address

588 William R. Latham Senior Dr. Suite #2
Bourbonnais, IL 60914

Phone

(815) 933-6100

NPI assigned

Aug 13, 2025

Organization subpart

No

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

Authorized official

Name

Mark J. Beck, DMDNPI 1255886552

Title

Owner

Phone

(630) 805-1687

Specialties & licenses 1

Addresses

Other names 1

• Revere Dental Doing business as

Tax ID family

Beck Dental PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Beck Dental PLLC

  • Dental Clinic/Center
  • Bourbonnais, IL
  • NPI 1245112333
  NPD tax ID

Locations

Practitioners 1

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

• Mark J. Beck, D.M.D.

  • Dentist
  • Wheaton, IL
  • NPI 1255886552
  NPD Authorized official

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

{
    "created_epoch": "1755043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755043200000",
    "number": "1902782154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "588 WILLIAM R. LATHAM SENIOR DR. SUITE #2",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "60914",
            "telephone_number": "815-933-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "588 WILLIAM R. LATHAM SENIOR DR. SUITE #2",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "60914",
            "telephone_number": "815-933-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BECK DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-13",
        "last_updated": "2025-08-13",
        "status": "A",
        "authorized_official_last_name": "BECK",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-805-1687",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revere Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sagar Batish
• Marian Baud, LCSW
• Beacon Counseling and Wellness LLC
• Ashley Beard, BCBA, LBA
• Beck Dental PLLC
• Jamie Jo Beedle, MSW
• Chelsea Diane Beers
• Jabiz Behzadpour, DO
• Emily Jacqueline Belschner
• Bemyhope Inc.

• General Practice Dentistry in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; 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.