Provider Demographics
NPI:1740304922
Name:BEANE, RICHARD ALLEN JR (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ALLEN
Last Name:BEANE
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1717 LEGION RD STE 203
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-2396
Mailing Address - Country:US
Mailing Address - Phone:919-240-7280
Mailing Address - Fax:919-240-7316
Practice Address - Street 1:121 S ESTES DR STE 206A
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2846
Practice Address - Country:US
Practice Address - Phone:919-928-0105
Practice Address - Fax:919-928-0630
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC40351223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89-90506Medicaid