Provider Demographics
NPI:1396186896
Name:BECKMANN, BRIANNA ALISON (DDS)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:ALISON
Last Name:BECKMANN
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 1:135 S SHARON AMITY RD STE 204
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-3871
Mailing Address - Country:US
Mailing Address - Phone:704-365-2765
Mailing Address - Fax:
Practice Address - Street 1:135 S SHARON AMITY RD STE 204
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-3871
Practice Address - Country:US
Practice Address - Phone:043-652-7657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2019-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC105581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice