Active NPI
Benjamin An, DDS
- Dentist
- San Francisco, CA
National Provider Identifier
1043043912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 110445
- Practice address
- 2340 Judah St
San Francisco, CA 94122-1539 - Phone
- (415) 665-8404
- NPI assigned
- Aug 24, 2024
- Sex
- Male
- Sole proprietor
- No
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 | 110445 | CA | Primary |
Addresses
Primary practice location
2340 Judah St
San Francisco, CA 94122-1539
Mailing address
100 Tobin Clark Dr
Hillsborough, CA 94010-7444
Phone (415) 990-8618
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 |
|---|---|---|---|
| 110445 | CA | MD | Day Training/Habilitation Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724457600000",
"number": "1043043912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 TOBIN CLARK DR",
"city": "HILLSBOROUGH",
"state": "CA",
"postal_code": "940107444",
"telephone_number": "415-990-8618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2340 JUDAH ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941221539",
"telephone_number": "415-665-8404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AN",
"first_name": "BENJAMIN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-08-24",
"last_updated": "2024-08-24",
"certification_date": "2024-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "110445",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.