Individual provider Active NPI

William Lee Beasley I, DDS

  • Endodontics
  • Oklahoma City, OK
National Provider Identifier
1982616256
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
3587 Issued in OK
Practice address
4500 Memorial Cir
Oklahoma City, OK 73142-5003
Phone
(405) 755-0251
NPI assigned
Aug 13, 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
Endodontics 1223E0200X 3587 OK Primary

Addresses

Primary practice location

4500 Memorial Cir
Oklahoma City, OK 73142-5003

Mailing address

4500 Memorial Cir
Oklahoma City, OK 73142-5003
Phone (405) 755-0251

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110913000760 OK Order and Referring Only - Oral SurgeryPractitioner - Oral SurgeryPractitioner - Other (Physician) 7810168325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3587OKMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Endodontic Associates PLLC Endodontics PastSince Jul 27, 2020 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982616256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL CIR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731425003",
            "telephone_number": "405-755-0251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL CIR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731425003",
            "telephone_number": "405-755-0251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEASLEY",
        "first_name": "WILLIAM",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "OK",
            "license": "3587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.