Provider Demographics
NPI:1255045399
Name:BEAM DENTAL PLLC
Entity type:Organization
Organization Name:BEAM DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHUHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAMBILLE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:918-605-2603
Mailing Address - Street 1:1144 N 38TH ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74014-1312
Mailing Address - Country:US
Mailing Address - Phone:918-994-0028
Mailing Address - Fax:918-994-0908
Practice Address - Street 1:1144 N 38TH ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74014-1312
Practice Address - Country:US
Practice Address - Phone:918-994-0028
Practice Address - Fax:918-994-0908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-12
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental