BEAUMONT SMILES YOUTH DENTISTRY, PLLC (NPI# 1982818498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982818498 |
| Entity Type | Organization |
| Organization Name | BEAUMONT SMILES YOUTH DENTISTRY, PLLC |
| Practice Address |
3865 Phelan Blvd Beaumont TX 77707-2243 |
| Mailing Address |
16 Arcade Unit 198747 Nashville TN 37219-1994 |
| Practice Telephone | 4098335497 |
| Practice Fax Number | 4098335441 |
| Mailing Telephone | 6157500343 |
| Mailing Fax Number | 6159861705 |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2014-07-09 |
| Authorized Official Name | MRS. JENELL STUMP (MANAGER, LICENSING & CREDENTIALING) |
| Authorized Official Telephone | 6157500343 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 184854101 | 05 |
| Street Address |
3865 PHELAN BLVD |
| City | BEAUMONT |
| State | TX |
| Zip Code | 77707-2243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750479069 | Hyacinth Erica Bailey | Dentist | 3865 Phelan Blvd, Beaumont, TX 77707-2243 | 2006-10-11 |
| 1316356082 | Phelan Dental Health Center Pllc | Dentist | 3865 Phelan Blvd, Beaumont, TX 77707-2243 | 2014-08-07 |
| 1972733533 | Sushma Kailash Pati | Dentist | 3865 Phelan Blvd, Beaumont, TX 77707-2243 | 2009-07-16 |
| 1578700639 | Sean Tran | Dentist | 3865 Phelan Blvd, Beaumont, TX 77707-2243 | 2009-01-12 |
| 1770750036 | Martha Jo Hudson | Dentist | 3865 Phelan Blvd, Beaumont, TX 77707-2243 | 2008-05-14 |
| 1932319357 | Gloria Jean King | Dentist | 3865 Phelan Blvd, Beaumont, TX 77707-2243 | 2007-05-23 |
| 1184741704 | Small Smiles of Beaumont, PC | Dentist | 3865 Phelan Blvd, Beaumont, TX 77707-2243 | 2007-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437718004 | Kelsey Marie Burt | Speech-Language Pathologist | 87 I-10, Beaumont, TX 77707 | 2019-06-07 |
| 1245898808 | Primary Care Anywhere, Pllc | Nurse Practitioner | 4347 Phelan, Suite 101, Beaumont, TX 77707 | 2019-05-30 |
| 1598321663 | Kacy Keitha Priddy | Occupational Therapist | 1846 I-10 S, Suite 102, Beaumont, TX 77707 | 2019-05-14 |
| 1144791963 | Jeffery Ray Manzer | Counselor | 3350 Dowlen Rd Suite J, Beaumont, TX 77707 | 2018-12-06 |
| 1497247217 | Haley Hebert | Speech-Language Pathologist | 87 I 10 N, Suite 225, Beaumont, TX 77707 | 2018-06-06 |
| 1548712383 | Taylor Miguez | Speech-Language Pathologist | 87 I-10 Frontage Rd #225, Beaumont, TX 77707 | 2016-10-27 |
| 1720534043 | Jacie Woodson | Speech-Language Pathologist | 87 I-10 Frontage Rd. 225, Beaumont, TX 77707 | 2016-08-28 |
| 1285187047 | Paula Boudreaux | Speech-Language Pathologist | 87 I-10 Frontage Rd, Suite 225, Beaumont, TX 77707 | 2016-07-28 |
| 1790138568 | Meagan Alyse Hartwick | Speech-Language Pathologist | 87 I-10 Frontage Rd., 225, Beaumont, TX 77707 | 2016-07-18 |
| 1376992578 | Laurie Lynette Jansky | Family Medicine | 3650 Laurel Ave, Beaumont, TX 77707 | 2016-06-08 |
| Find all providers in zip 77707 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407319213 | Legacy Dental of Beaumont Pllc | Dentist | 6480 Eastex Fwy Ste A, Beaumont, TX 77708-4336 | 2019-04-09 |
| 1821557604 | Tamarra Jean-chataigne | Dentist | 860 S 11th St Ste 101, Beaumont, TX 77701-3737 | 2019-03-19 |
| 1982199923 | Nikita Chandrakant Patel | Dentist | 5030 Oakmont Dr, Beaumont, TX 77706-7641 | 2018-06-22 |
| 1770008088 | Jonathan Howard Callahan | Dentist | 5892 Eastex Fwy Ste B, Beaumont, TX 77708-4824 | 2017-08-08 |
| 1821446055 | La Costa of Beaumont Pa | Dentist | 3870 College Street, Suite #200, Beaumont, TX 77701 | 2016-05-27 |
| 1770860801 | Arthur Donald Shaw | Dentist | 3875 Laurel St, Beaumont, TX 77707-2219 | 2011-11-03 |
| 1356660260 | Ss Powers Dental, P.a. | Dentist | 4825 Concord Rd, Beaumont, TX 77703-1811 | 2010-05-18 |
| 1174774699 | Moore Dental Corporation | Dentist | 1620 2nd Street Marketplace, Suite A, Beaumont, CA 92223 | 2008-10-02 |
| 1457509424 | Gaurav Puri | Dentist | 4400 Highland Ave, Beaumont, TX 77705 | 2008-09-03 |
| 1881864056 | David M Caldwell Dds PC | Dentist | 715 Orleans St, Beaumont, TX 77701 | 2008-03-04 |
| Find all providers in BEAUMONT | ||||
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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.