Provider Demographics
NPI:1891101697
Name:BEERPUR, CHAKRADHAR (DDS)
Entity Type:Individual
Prefix:
First Name:CHAKRADHAR
Middle Name:
Last Name:BEERPUR
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 1:2920 MUIRFIELD DR
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-4155
Mailing Address - Country:US
Mailing Address - Phone:646-593-1660
Mailing Address - Fax:
Practice Address - Street 1:1401 S JEFFERSON AVE
Practice Address - Street 2:STE 4
Practice Address - City:MOUNT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-5643
Practice Address - Country:US
Practice Address - Phone:646-593-1660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-01
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX#30210122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX#30210OtherTEXAS LICENSED DENTIST