Individual provider Active NPI

Nicholas Sewell Bennett, D.D.S.

  • Dentist
  • Baltimore, MD
National Provider Identifier
1003044603
Registry record updated Jun 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
PENDING Issued in MD
Practice address
10 N Greene St
2-D-137
Baltimore, MD 21201-1524
Phone
(410) 605-7056
NPI assigned
Jun 23, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X PENDING MD Primary

Addresses

Primary practice location

10 N Greene St
2-D-137
Baltimore, MD 21201-1524

Mailing address

10 N Greene St
2-D-137
Baltimore, MD 21201-1524
Phone (410) 605-7056

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20240102001157 MD Order and Referring Only - DentistPractitioner - Dentist 3173817871

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PENDINGMDMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245715200000",
    "number": "1003044603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 N GREENE ST",
            "address_2": "2-D-137",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011524",
            "telephone_number": "410-605-7056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 N GREENE ST",
            "address_2": "2-D-137",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011524",
            "telephone_number": "410-605-7056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "NICHOLAS",
        "middle_name": "SEWELL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-23",
        "last_updated": "2009-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.