MEDICARE: DR. BEAU CHRISTOPHER BYERS DMD, MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	12014556A	IN

General Provider Information

NPI Number	:	1932094059
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BEAU CHRISTOPHER BYERS DMD, MS

Provider Business Mailing Address
First Line	:	17 SCOFIELD CT
Second Line	:
City	:	BLOOMINGTON
State	:	IL
Zip	:	61704-4809
Country	:	US
Telephone Number	:	309-830-4750
Fax Number	:

Provider Business Practice Location Address
First Line	:	8445 S EMERSON AVE STE 102
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46237-9597
Country	:	US
Telephone Number	:	317-888-2827
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2025
Last Update Date	:	06/10/2025

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