Provider Demographics
NPI:1235842279
Name:HEATHER BEATY, DDS, INC
Entity Type:Organization
Organization Name:HEATHER BEATY, DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:BEATY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:937-602-0318
Mailing Address - Street 1:7400 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:CA
Mailing Address - Zip Code:95658-9430
Mailing Address - Country:US
Mailing Address - Phone:937-602-0318
Mailing Address - Fax:
Practice Address - Street 1:196 LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-4416
Practice Address - Country:US
Practice Address - Phone:530-885-3368
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty