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DR. BEAU UPSHAW D.M.D.
NPI 1578976098
Dentist - General Practice in Loganville, GA

Active since June 03, 2014PECOS Enrolled
3238 KRISAM CREEK DR, LOGANVILLE, GA 30052(770) 466-0474 Get Directions Write a Review

NPPES record last updated: October 28, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Beau Upshaw D.m.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. BEAU UPSHAW D.M.D. (NPI 1578976098) is an individual general practice provider in Loganville, Georgia, licensed in Georgia (DN014781) and active in the NPI registry since June 2014. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1578976098
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. BEAU UPSHAWCredential: D.M.D.
Location Address3238 KRISAM CREEK DRLoganville, GA 30052-7942
Mailing Address3238 Krisam Creek DrLoganville, GA 30052-7942
Phone(770) 466-0474
Sole ProprietorNo
Enumeration DateJune 3, 2014
Last NPPES UpdateOctober 28, 2014
✔ NPI 1578976098 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in GA · DN014781
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
3238 KRISAM CREEK DR, Loganville, GA 30052
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Beau Upshaw D.m.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30052 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$70.85 typical visit price
range $18.22 – $140.40
Typical copayment $17.71 (range $4.55 – $35.10)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. STEWART HELTON D.M.D
Dentist (General Practice)
3238 KRISAM CREEK DR
LOGANVILLE, GA 30052
Gwinnett County (770) 466-0474
CREEKSIDE DENTISTRY, LLC
Dentist (General Practice)
3238 KRISAM CREEK DR
LOGANVILLE, GA 30052
Gwinnett County (770) 466-0474

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Beau Upshaw's NPI number?

The NPI number for Beau Upshaw is 1578976098. It was assigned to this individual provider in the NPPES registry on June 3, 2014.

Where is Beau Upshaw located?

Beau Upshaw practices at 3238 Krisam Creek Dr, Loganville, GA 30052. The listed phone number is (770) 466-0474.

What is Beau Upshaw's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Beau Upshaw enrolled in Medicare?

Yes. Beau Upshaw is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Beau Upshaw was last updated on October 28, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.