Individual provider Active NPI

Bruce Fredrick Beard, D.D.S.

  • General Practice Dentistry
  • Woodland Hills, CA
National Provider Identifier
1952657793
Registry record updated Jul 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
27260 Issued in CA
Practice address
22600 Ventura Blvd
Suite 204
Woodland Hills, CA 91364-1414
Phone
(818) 225-0046
Fax
(818) 225-1318
NPI assigned
Jul 30, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 27260 CA Primary

Addresses

Primary practice location

22600 Ventura Blvd
Suite 204
Woodland Hills, CA 91364-1414

Mailing address

22600 Ventura Blvd
Suite 204
Woodland Hills, CA 91364-1414
Phone (818) 225-0046

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150414000564 CA Order and Referring Only - Other (Non-Physician) 6406011873

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27260CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Beard Apc & Fernandez Adc Dental Group CurrentSince Mar 5, 2012 Accepting new patients

Locations

22600 Ventura Blvd
Ste 204
Woodland Hls, CA 91364
Phone (818) 225-0046

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343606400000",
    "number": "1952657793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22600 VENTURA BLVD",
            "address_2": "SUITE 204",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641414",
            "telephone_number": "818-225-0046",
            "fax_number": "818-225-1318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22600 VENTURA BLVD",
            "address_2": "SUITE 204",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641414",
            "telephone_number": "818-225-0046",
            "fax_number": "818-225-1318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEARD",
        "first_name": "BRUCE",
        "middle_name": "FREDRICK",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-30",
        "last_updated": "2012-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "27260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Hills, CA

Sources for this page

Verify at the official NPI Registry.