Individual provider Active NPI

Rebecca Leigh Benson, D.D.S.

  • General Practice Dentistry
  • Richfield, MN
National Provider Identifier
1003043175
Registry record updated Jun 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D12666 Issued in MN
Practice address
6601 Lyndale Ave S
Richfield, MN 55423-2477
Phone
(612) 866-1234
NPI assigned
Jun 16, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D12666 MN Primary

Addresses

Primary practice location

6601 Lyndale Ave S
Richfield, MN 55423-2477

Mailing address

3241 Sumter Ave S
St Louis Park, MN 55426-3612
Phone (651) 334-6263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160113002736 MN Order and Referring Only - DentistPractitioner - Dentist 9032411608

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D12666MNMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245110400000",
    "number": "1003043175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3241 SUMTER AVE S",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554263612",
            "telephone_number": "651-334-6263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 LYNDALE AVE S",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232477",
            "telephone_number": "612-866-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENSON",
        "first_name": "REBECCA",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-16",
        "last_updated": "2009-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richfield, MN

Sources for this page

Verify at the official NPI Registry.