BURKE AND BECKSTROM ORTHODONTICS (NPI# 1235601659) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235601659 |
| Entity Type | Organization |
| Organization Name | BURKE AND BECKSTROM ORTHODONTICS |
| Practice Address |
446 S Mall Dr Ste 100 St George UT 84790-4944 |
| Mailing Address |
1100 Canyon View Dr Santa Clara UT 84765-5671 |
| Practice Telephone | 4356733334 |
| Mailing Telephone | 4356286200 |
| Enumeration Date | 2018-12-24 |
| Last Update Date | 2018-12-24 |
| Authorized Official Name | BRIAN LEE BECKSTROM (ORTHODONTIST, OWNER) |
| Authorized Official Telephone | 4356286200 |
| Authorized Official Credential | DDS, MSD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| INDIVIDUAL NPI-BRANDON G. BURKE | 1215249982 | 01 | |
| INDIVIDUAL NPI-BRIAN L. BECKSTROM | 1396035416 | 01 | |
| UT | UTAH DENTAL LICENSE-BRANDON G. BURKE | 7598338-9921 | 01 |
| UT | UTAH DENTAL LICENSE-BRIAN L. BECKSTROM | 9366743-9921 | 01 |
| NV | NEVADA DENTAL LICENSE-BRANDON G. BURKE | S3-216C | 01 |
| NEVADA DENTAL LICENSE-BRIAN L. BECKSTROM | S3-248 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1100 Canyon View Dr, Santa Clara, UT 847655671 | 4356286200 |
| Street Address |
446 S MALL DR STE 100 |
| City | ST GEORGE |
| State | UT |
| Zip Code | 84790-4944 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467916528 | Wisdom Teeth of Southern Utah | Dentist | 446 S Mall Dr Ste 100, St George, UT 84790-4944 | 2019-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342713 | Katrina Poulsen | Student in an Organized Health Care Education/Training Program | 617 East Rriverside Dr, Ste 301, St. George, UT 84790 | 2020-10-08 |
| 1124643226 | Desert View Eyecare | Optometrist | 15 South River Road St. 150, St. George, UT 84790 | 2020-06-15 |
| 1366066417 | Benjamin Todd Lloyd | Dentist | 1683 E. Wolf Hole Dr, St. George, UT 84790 | 2020-06-04 |
| 1801434584 | Jennifer M Putnam | Marriage & Family Therapist | 321 North Mall Drive, Vw103, St. George, UT 84790 | 2019-12-12 |
| 1326683012 | Red Mountain Counseling and Education | Counselor | 321 No Mall Dr, Vw 103, St. George, UT 84790 | 2019-11-17 |
| 1295376002 | Karynne Kimberly Simpson | Behavior Technician | 280 N 1680 E U1, St. George, UT 84790 | 2019-10-02 |
| 1962053017 | Mikala Larsen | Nurse Practitioner | 1380 S Medical Center Dr., Saint George, UT 84790 | 2019-09-20 |
| 1326690678 | Joe Ballent | Student in an Organized Health Care Education/Training Program | 1526 S Medical Center Dr Ste 224a, St George, UT 84790 | 2019-07-16 |
| 1558923854 | David Pace | Optometrist | 749 South River Rd, St. George, UT 84790 | 2019-07-08 |
| 1639734924 | Mariah Ann Mertlich | Behavioral Analyst | 280 N 1680 E, U1, St. George, UT 84790 | 2019-05-02 |
| Find all providers in zip 84790 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346884335 | Orthodontics of St. George, P.C. | Dentist | 965 E 700 S Ste 101, St George, UT 84790-4084 | 2019-11-01 |
| 1457749285 | Jeff W Erickson | Dentist | 640 E 700 S Ste 301, St George, UT 84770-5741 | 2015-01-01 |
| 1396035416 | Brian Beckstrom | Dentist | 1091 N Bluff St Ste 550, St George, UT 84770 | 2011-04-10 |
| 1386865459 | Bradley G Simister | Dentist | 1054 E Riverside Dr Ste 101, St George, UT 84790-4740 | 2007-05-02 |
| 1053478420 | Brice William Beckstrom | Dentist | 1091 N Bluff St, Suite 550, St George, UT 84770-4894 | 2007-01-03 |
| 1174057319 | Brian L. Beckstrom P.C. | Dentist | 1091 N Bluff St, Suite 550, St George, UT 84770-4894 | 2017-04-14 |
| 1215478425 | Spendlove Orthodontics, Pllc | Dentist | 965 E 700 S, #101, St George, UT 84790-4082 | 2017-03-20 |
| 1710254792 | Randy T Simonsen | Dentist | 10 Diagonal St, St George, UT 84770-2878 | 2011-11-19 |
| 1972782621 | Orthodontic Specialists LLC | Dentist | 640 East 700 South, Suite 301, St George, UT 84770 | 2007-10-30 |
| 1235332719 | Wayne J Christian | Dentist | 330 E Tabernacle St, Suite B, St George, UT 84770-3093 | 2007-06-11 |
| Find all providers in ST GEORGE | ||||
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| 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.