Provider Demographics
NPI:1275660813
Name:BECKFORD, YVONNE E (DDS)
Entity Type:Individual
Prefix:DR
First Name:YVONNE
Middle Name:E
Last Name:BECKFORD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3983 LAVISTA RD
Mailing Address - Street 2:SUITE 181
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-5153
Mailing Address - Country:US
Mailing Address - Phone:770-939-9293
Mailing Address - Fax:770-939-4716
Practice Address - Street 1:3983 LAVISTA RD
Practice Address - Street 2:SUITE 181
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-5153
Practice Address - Country:US
Practice Address - Phone:770-939-9293
Practice Address - Fax:770-939-4716
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA103001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA590789OtherUNITED CONCORDIA
GAT1000748OtherWEBMD CORPORATON
GA100705OtherAVESIS
GA108547OtherDORAL