Healthcare Provider Details

I. General information

NPI: 1912132333
Provider Name (Legal Business Name): ERIC MARTIN BECKMAN DDS MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2009
Last Update Date: 07/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 S PEORIA ST BUILDING D
AURORA CO
80014-5712
US

IV. Provider business mailing address

2900 SOUTH PEORIA STREET BUILDING D
AURORA CO
80014
US

V. Phone/Fax

Practice location:
  • Phone: 303-755-4500
  • Fax: 303-755-4047
Mailing address:
  • Phone: 303-755-4500
  • Fax: 303-755-4047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberD12539
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number10713
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberD12539
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: