DR. VIRGIL A BEADLE (NPI# 1609943091) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1609943091 |
Entity Type | Individual |
Full Name | DR. VIRGIL A BEADLE |
Credential | DDX |
Practice Address |
#4 Crown Lane Carbondale IL 62903-7604 |
Practice Telephone | 6184574137 |
Practice Fax Number | 6183511081 |
Mailing Telephone | 6184574137 |
Mailing Fax Number | 6183511081 |
Enumeration Date | 2006-11-29 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 122300000X | Dentist | 010711 | MO | Dental Providers |
Y | 122300000X | Dentist | 19A12875 | IL | Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MO | STATE OF MISSOURI | 010711 | 01 |
IL | STATE OF ILLINOIS | 19A12875 | 01 |
Street Address |
#4 CROWN LANE |
City | CARBONDALE |
State | IL |
Zip Code | 62903-7604 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447625918 | Integrative Spine Care, LLC | Pain Medicine | 364 Lake Indian Hills Circle, Carbondale, IL 62903 | 2015-12-09 |
1811949910 | Devon G Barnes | Nurse Anesthetist, Certified Registered | 35 Albany Road, Suite C, Carbondale, IL 62903 | 2006-05-17 |
1316282130 | Centerstone of Illinois, Inc | Community/Behavioral Health | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2012-12-05 |
1861009128 | Ashley Pruett | Counselor | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2020-09-30 |
1477167823 | Zachary Woosley | Counselor | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2020-09-03 |
1215553110 | Margaret K Henry | Counselor | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2020-06-17 |
1053934489 | Matthew Picchietti | Counselor | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2020-05-20 |
1487287835 | Lyndsey Wideman | Counselor | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2020-02-13 |
1124659024 | Matthew Leigh | Counselor | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2020-01-29 |
1447890199 | Nicholas Foy | Counselor | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2020-01-10 |
Find all providers in zip 62903 |
Taxonomy Code | 122300000X |
Grouping | Dental Providers |
Classification | Dentist |
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396084182 | Gary Michael Brown | Dentist | 660 Drury Rd, Carbondale, IL 62902-7463 | 2013-02-13 |
1902119837 | Scott Michael Bietsch | Dentist | 402 S Lewis Ln, Carbondale, IL 62901-3547 | 2010-07-20 |
1902117336 | Valerie N Spivey | Dentist | 402 South Lewis Lane, Carbondale, IL 62901 | 2010-06-30 |
1174859870 | Shawnee Health Service & Development Corp | Dentist | 402 S. Lewis Lane, Carbondale, IL 62901 | 2009-10-30 |
1598904591 | Bryan M Goldesberry | Dentist | 1366 E Main St, Carbondale, IL 62901-3144 | 2009-02-13 |
1093838005 | Mark Alan Cook | Dentist | 60 S 8th St Unit 201, Carbondale, CO 81623-1929 | 2007-04-06 |
1861596934 | Clifford G Neill | Dentist | 307 S University, Carbondale, IL 62901 | 2006-09-11 |
1972532398 | Charles Bernard Brown | Dentist | 58 8th Ave, Carbondale, PA 18407-2297 | 2006-06-30 |
1023008364 | Dwayne Gail Summers | Dentist | 1365 Douglas Dr, Carbondale, IL 62901-2583 | 2005-10-27 |
1710974795 | Jonathan W Burton | Dentist | 2250 N Reed Station Rd, Suite 201, Carbondale, IL 62901-8101 | 2005-10-04 |
Find all providers in CARBONDALE |
City | CARBONDALE |
Zip Code | 62903 |
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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.