1427465467 NPI number — DR. MEGAN KINKELAAR BEAM DDS

Table of content: DR. MEGAN KINKELAAR BEAM DDS (NPI 1427465467)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427465467 NPI number — DR. MEGAN KINKELAAR BEAM DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BEAM
Provider First Name:
MEGAN
Provider Middle Name:
KINKELAAR
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KINKELAAR
Provider Other First Name:
MEGAN
Provider Other Middle Name:
RENEE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DDS
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1427465467
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/07/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5 N. MORGANTOWN ST.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAIRCHANCE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15436
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-564-9010
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5 N. MORGANTOWN ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAIRCHANCE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15436
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-564-9010
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/22/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  30.024297 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)