Provider Demographics
NPI:1689484438
Name:KBS FAMILY DENTAL, KERRI BEEDY-STORTS DDS, LLC
Entity type:Organization
Organization Name:KBS FAMILY DENTAL, KERRI BEEDY-STORTS DDS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:KERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:BEEDY-STORTS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:937-207-4328
Mailing Address - Street 1:2825 BROADVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45505-3405
Mailing Address - Country:US
Mailing Address - Phone:937-207-4328
Mailing Address - Fax:
Practice Address - Street 1:1758 COMMERCE CENTER BLVD STE B
Practice Address - Street 2:
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324-6358
Practice Address - Country:US
Practice Address - Phone:937-879-9906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-13
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental