Active NPI
Beavers Family Dentistry
- General Practice Dentistry
- Clinton, AR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 3357
- Legal business name
- BEAVERS FAMILY DENTISTRY
- Practice address
- 644 Main St
Clinton, AR 72031-6602 - Phone
- (501) 745-8811
- NPI assigned
- May 30, 2007
- Last updated
- Jan 21, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- James V Beavers, DDS
- Title
- General Dentist
- Phone
- (501) 745-8811
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) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 3357 | AR | Primary |
Addresses
Primary practice location
644 Main St
Clinton, AR 72031-6602
Mailing address
644 Main St
Clinton, AR 72031-6602
Phone (501) 745-8811
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 143573608 | Medicaid | AR |
National Provider Directory
National Provider Directory- Tax ID family
- Beavers Family Dentistry
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- General Practice Dentistry
- Clinton, AR
- NPI 1740898584
Locations
644 Main St
Clinton, AR 72031
Phone (501) 745-8811
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- General Practice Dentistry
- Clinton, AR
- NPI 1134165335
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180483200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1232496000000",
"number": "1942401666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "644 MAIN ST",
"city": "CLINTON",
"state": "AR",
"postal_code": "720316602",
"telephone_number": "501-745-8811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "644 MAIN ST",
"city": "CLINTON",
"state": "AR",
"postal_code": "720316602",
"telephone_number": "501-745-8811"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BEAVERS FAMILY DENTISTRY",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-30",
"last_updated": "2009-01-21",
"status": "A",
"authorized_official_last_name": "BEAVERS",
"authorized_official_first_name": "JAMES",
"authorized_official_middle_name": "V",
"authorized_official_title_or_position": "GENERAL DENTIST",
"authorized_official_telephone_number": "501-745-8811",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AR",
"license": "3357",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "143573608",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clinton, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.