Provider Demographics
NPI:1922138692
Name:KIRKPATRICK, JESSE BECK (DDS)
Entity Type:Individual
Prefix:DR
First Name:JESSE
Middle Name:BECK
Last Name:KIRKPATRICK
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 1:4201 GARTH RD
Mailing Address - Street 2:SUITE 311
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-3167
Mailing Address - Country:US
Mailing Address - Phone:281-427-5305
Mailing Address - Fax:281-471-3577
Practice Address - Street 1:4201 GARTH RD
Practice Address - Street 2:SUITE 311
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3167
Practice Address - Country:US
Practice Address - Phone:281-427-5305
Practice Address - Fax:281-471-3577
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU15980Medicare UPIN