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Contact Information

JOHN G BEACK, DMD
13210 SE 240TH ST. SUITE B-1
KENT, WA98042
 Phone: 253-631-8490
 Fax: 253-639-3929
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for JOHN G BEACK · (Male)

NPI Number 1134205842
Status Active
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 10/27/2006
Last updated 02/11/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • WA License # DE00010948
  • MA Medicaid 0205681
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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