Timothy Paul Bennett, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

28517 Issued in CA

Practice address

721 Pleasant Grove Blvd Ste 150
Roseville, CA 95678-6181

Phone

(916) 865-2252

NPI assigned

Oct 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391040000000",
    "number": "1033205901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 PIZARRO AVE",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949496149",
            "telephone_number": "415-302-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 PLEASANT GROVE BLVD STE 150",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956786181",
            "telephone_number": "916-865-2252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "TIMOTHY",
        "middle_name": "PAUL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2014-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "28517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benessere Marriage and Family Therapy, Inc
• Ranell Leigh Benfield
• Benjamin Van Pham
• Jessie Sophia Bennett, PA-C
• Robert Winston Bennett Jr., PH.D.
• Nicole Renee Bennington-McKay, MD
• Tarra Benoist
• Andre Tedrell Benson
• John Christopher Benson, DPM
• Regina Benson, CVD(TVL)

• Dentist in Roseville, CA
• Providers in Roseville, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.