Provider Demographics
NPI:1326372319
Name:BEECROFT, ZACHARY JAMES (DDS)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:JAMES
Last Name:BEECROFT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:ZACHARY
Other - Middle Name:J
Other - Last Name:BEECROFT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:6703 S LOUISE AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108
Mailing Address - Country:US
Mailing Address - Phone:605-271-9330
Mailing Address - Fax:605-271-9331
Practice Address - Street 1:6703 S. LOUISE AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108
Practice Address - Country:US
Practice Address - Phone:605-271-9330
Practice Address - Fax:605-271-9331
Is Sole Proprietor?:No
Enumeration Date:2009-09-24
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDD09191223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist