Active NPI
Benjamin Reece Myers, DMD
- Dentist
- Kosciusko, MS
National Provider Identifier
1013291228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 3623-11
- Practice address
- 500 Veterans Memorial Dr
Kosciusko, MS 39090-3858 - Phone
- (662) 289-4781
- Fax
- (662) 289-6143
- NPI assigned
- Oct 6, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 3623-11 | MS | Primary |
Addresses
Primary practice location
500 Veterans Memorial Dr
Kosciusko, MS 39090-3858
Mailing address
500 Veterans Memorial Dr
Kosciusko, MS 39090-3858
Phone (662) 289-4781
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3623-11 | MS | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317859200000",
"number": "1013291228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 VETERANS MEMORIAL DR",
"city": "KOSCIUSKO",
"state": "MS",
"postal_code": "390903858",
"telephone_number": "662-289-4781",
"fax_number": "662-289-6143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 VETERANS MEMORIAL DR",
"city": "KOSCIUSKO",
"state": "MS",
"postal_code": "390903858",
"telephone_number": "662-289-4781",
"fax_number": "662-289-6143"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MYERS",
"first_name": "BENJAMIN",
"middle_name": "REECE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-06",
"last_updated": "2011-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MS",
"license": "3623-11",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kosciusko, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.