Individual provider Active NPI

Thomas Myron Beckman, D.D.S.

  • Pediatric Dentistry
  • Minneapolis, MN
National Provider Identifier
1962581520
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
D7658 Issued in MN
Practice address
515 Delaware Street S.E.
6-150 Moos Tower - University of Minnesota
Minneapolis, MN 55455
Phone
(612) 624-2161
Fax
(612) 626-2900
NPI assigned
Nov 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X D7658 MN Primary

Addresses

Primary practice location

515 Delaware Street S.E.
6-150 Moos Tower - University of Minnesota
Minneapolis, MN 55455

Mailing address

4675 120TH St W
Apple Valley, MN 55124-8629
Phone (952) 452-1802

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
D7658MNMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962581520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4675 120TH ST W",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551248629",
            "telephone_number": "952-452-1802",
            "fax_number": "612-626-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 DELAWARE STREET S.E.",
            "address_2": "6-150 MOOS TOWER - UNIVERSITY OF MINNESOTA",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-624-2161",
            "fax_number": "612-626-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKMAN",
        "first_name": "THOMAS",
        "middle_name": "MYRON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MN",
            "license": "D7658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.