Provider Demographics
NPI:1932094059
Name:BYERS, BEAU CHRISTOPHER (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:BEAU
Middle Name:CHRISTOPHER
Last Name:BYERS
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 SCOFIELD CT
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61704-4809
Mailing Address - Country:US
Mailing Address - Phone:309-830-4750
Mailing Address - Fax:
Practice Address - Street 1:8445 S EMERSON AVE STE 102
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-9597
Practice Address - Country:US
Practice Address - Phone:317-888-2827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12014556A1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics