Provider Demographics
NPI:1487632139
Name:BECKER, THOMAS DEAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:DEAN
Last Name:BECKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 28TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1430
Mailing Address - Country:US
Mailing Address - Phone:515-224-4455
Mailing Address - Fax:515-224-4040
Practice Address - Street 1:1450 28TH ST
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1430
Practice Address - Country:US
Practice Address - Phone:515-224-4455
Practice Address - Fax:515-224-4040
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20050264721223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics