Provider Demographics
NPI:1609388131
Name:BEATI LLC
Entity Type:Organization
Organization Name:BEATI LLC
Other - Org Name:SPRING SMILE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAEHEE
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-335-3416
Mailing Address - Street 1:3535 N BUCKNER BLVD STE 114
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-5633
Mailing Address - Country:US
Mailing Address - Phone:214-321-7777
Mailing Address - Fax:214-321-7776
Practice Address - Street 1:3535 N BUCKNER BLVD STE 114
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-5633
Practice Address - Country:US
Practice Address - Phone:214-321-7777
Practice Address - Fax:214-321-7776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-24
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23243261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental