Provider Demographics
NPI:1427465467
Name:BEAM, MEGAN KINKELAAR (DDS)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:KINKELAAR
Last Name:BEAM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:RENEE
Other - Last Name:KINKELAAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:5 N. MORGANTOWN ST.
Mailing Address - Street 2:
Mailing Address - City:FAIRCHANCE
Mailing Address - State:PA
Mailing Address - Zip Code:15436
Mailing Address - Country:US
Mailing Address - Phone:724-564-9010
Mailing Address - Fax:
Practice Address - Street 1:5 N. MORGANTOWN ST.
Practice Address - Street 2:
Practice Address - City:FAIRCHANCE
Practice Address - State:PA
Practice Address - Zip Code:15436
Practice Address - Country:US
Practice Address - Phone:724-564-9010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-22
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0242971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice