NATHAN K. BEAVERS DMD PLLC (NPI# 1003138967) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003138967 |
| Entity Type | Organization |
| Organization Name | NATHAN K. BEAVERS DMD PLLC |
| Practice Address |
119 Colony Crossing Way Suite 740 Madison MS 39110-6322 |
| Practice Telephone | 6018565313 |
| Mailing Telephone | 6018565313 |
| Enumeration Date | 2010-02-19 |
| Last Update Date | 2010-02-19 |
| Authorized Official Name | DR. NATHAN BEAVERS (MANAGING PARTNER) |
| Authorized Official Telephone | 6018565313 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
PEDO 377-04 | MS | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 05382775 | 05 |
| Street Address |
119 COLONY CROSSING WAY SUITE 740 |
| City | MADISON |
| State | MS |
| Zip Code | 39110-6322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790849404 | Nathan Keil Beavers | Dentist | 119 Colony Crossing Way, Suite 740, Madison, MS 39110-6322 | 2006-12-20 |
| 1639546542 | Anthony Reppond | Specialist/Technologist | 119 Colony Crossing Way, Ste 660, Madison, MS 39110-6322 | 2015-08-26 |
| 1649698564 | Miller Family Chiropractic Pa | Chiropractor | 119 Colony Crossing Way, Suite 700, Madison, MS 39110-6322 | 2014-03-29 |
| 1922281880 | Miller Family Chiropractic | Chiropractor | 119 Colony Crossing Way, Suite 700, Madison, MS 39110-6322 | 2007-12-13 |
| 1750574562 | James Ryan Miller | Chiropractor | 119 Colony Crossing Way, Suite 700, Madison, MS 39110 | 2007-08-24 |
| 1376744185 | Courtney Harwell Filgo | Dentist | 119 Colony Crossing Way, Suite 780, Madison, MS 39110-6322 | 2007-05-30 |
| 1255482592 | Sarah Crisler Carlisle | Dentist | 119 Colony Crossing Way, Suite 780, Madison, MS 39110-6322 | 2007-01-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134784689 | Therapy South - Gluckstadt LLC | Physical Therapist | 1716 Us 51, Ste N, Madison, MS 39110 | 2019-05-09 |
| 1871054098 | Summit Medical Solutions | Durable Medical Equipment & Medical Supplies | 107 Azalea Street, Madison, MS 39110 | 2019-03-29 |
| 1912488198 | Madison Medical Compounding Pharmacy | Pharmacy | 111 Fountains Blvd. Building B Ste. A, Madison, MS 39110 | 2018-08-24 |
| 1679061469 | Nuvena Vein Clinic | Anesthesiology | 120 Fountains Blvd, Madison, MS 39110 | 2018-04-26 |
| 1467960484 | Brick City Drugs, LLC | Durable Medical Equipment & Medical Supplies | 159 Fountains Blvd, Madison, MS 39110 | 2018-01-11 |
| 1093227589 | Hannah Monk Hawthorne | Counselor | 930 Ebenezer Blvd., Suite D, Madisin, MS 39110 | 2017-10-25 |
| 1548786650 | Kimberly Allen | Pharmacist | 1100 Us- 51, Madison, MS 39110 | 2017-08-21 |
| 1891218186 | Delta Elizabeth Stark | Chiropractor | 1085 Gluckstadt Rd., Bld 300 Ste E, Madison, MS 39110 | 2017-07-19 |
| 1861914848 | Laura Hartlein | Dietitian, Registered | 200 Park Circle Dr. #2, Flowood, MS 39110 | 2017-07-12 |
| 1831620608 | Ona Irby | Occupational Therapist | 105 Munich Dr, Madison, MS 39110 | 2017-03-23 |
| Find all providers in zip 39110 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629497656 | Corey Joseph Cloud | Dentist | 500 Lentz Dr Ste 40, Madison, TN 37115 | 2014-04-07 |
| 1023259546 | Northern Dental Specialists, Dr. Steven W Gajda | Dentist | 2040 Hubbard Road, Madison, OH 44057 | 2009-03-12 |
| 1417169160 | Children's Dental Center of Madison, S.c. | Dentist | 7001 Old Sauk Road, #200, Madison, WI 53717 | 2007-05-04 |
| 1982759791 | Pediatric Dentistry Associates, LLC | Dentist | 149 Durham Rd Ste 33, Madison, CT 06443-2680 | 2007-01-24 |
| 1790849404 | Nathan Keil Beavers | Dentist | 119 Colony Crossing Way, Suite 740, Madison, MS 39110-6322 | 2006-12-20 |
| 1164533345 | Douglas W Wilson | Dentist | 100 River Place, Suite 110, Madison, WI 53716 | 2006-08-31 |
| 1972614154 | Anthony R Hernandez | Dentist | 5116 American Family Dr, Madison, WI 53718-8331 | 2006-08-31 |
| 1720197403 | David Paul Lubbe | Dentist | 1739 Michigan Rd, Madison, IN 47250-2721 | 2006-08-29 |
| 1518928910 | Kurt Robert Swauger | Dentist | 500 Lentz Dr, Ste 40, Madison, TN 37115-5135 | 2006-03-28 |
| 1407838725 | Amy Elizabeth Kramer | Dentist | 7001 Old Sauk Rd, Madison, WI 53717-2308 | 2005-11-14 |
| Find all providers in MADISON | ||||
Please comment or provide details below to improve the information on NATHAN K. BEAVERS DMD PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.