Individual provider Active NPI

Kerri Danielle Beedy-Storts, DDS

  • Dentist
  • Fairborn, OH
National Provider Identifier
1942946801
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.026827 Issued in OH
Practice address
1758 Commerce Center Blvd
Fairborn, OH 45324-6358
Phone
(937) 879-9906
NPI assigned
May 12, 2022
Last updated
Jan 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.026827 OH Primary

Addresses

Primary practice location

1758 Commerce Center Blvd
Fairborn, OH 45324-6358

Mailing address

2825 Broadview Dr
Springfield, OH 45505-3405
Phone (937) 207-4328

Other practice location 1

2825 Broadview Dr
Springfield, OH 45505-3405
Phone (937) 207-4328

Other names 1

  • Kerri Danielle Beedy Former name

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
30.026827OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
KBS Family Dental, Kerri Beedy-Storts DDS, LLC CurrentSince Jan 19, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1942946801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 BROADVIEW DR",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455053405",
            "telephone_number": "937-207-4328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1758 COMMERCE CENTER BLVD",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453246358",
            "telephone_number": "937-879-9906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2825 Broadview Dr",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OH",
            "postal_code": "455053405",
            "country_code": "US",
            "telephone_number": "937-207-4328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEEDY-STORTS",
        "first_name": "KERRI",
        "middle_name": "DANIELLE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-12",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.026827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERRI",
            "last_name": "BEEDY",
            "middle_name": "DANIELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fairborn, OH

Sources for this page

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