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General NPI Number Information
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NPI Number | 1942946801
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Entity Type | Individual
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Provider Name | KERRI DANIELLE BEEDY-STORTS DDS
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Gender | Female
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Dates
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Enumeration Date | 05/12/2022
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 1758 COMMERCE CENTER BLVD
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City | FAIRBORN
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State | OH
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Zip | 45324-6358
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Country | US
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Telephone | 937-879-9906
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Fax |
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Provider Business Mailing Address
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Address Line | 2825 BROADVIEW DR
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City | SPRINGFIELD
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State | OH
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Zip | 45505-3405
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Country | US
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Telephone | 937-207-4328
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30.026827
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License Number State | OH
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