Jason R Benoit, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

08005 Issued in IA

Practice address

3024 Victoria St
Bettendorf, IA 52722-2793

Phone

(563) 332-2447

Fax

(563) 332-9787

NPI assigned

Jul 28, 2006

Last updated

Jul 9, 2007By the provider in NPPES

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• QC Dental Docs, P.C.

  • General Practice Dentistry
  • Bettendorf, IA
  • NPI 1033344130
  NPD (past)

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1043224637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 VICTORIA ST",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527222793",
            "telephone_number": "563-332-2447",
            "fax_number": "563-332-9787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3024 VICTORIA ST",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527222793",
            "telephone_number": "563-332-2447",
            "fax_number": "563-332-9787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENOIT",
        "first_name": "JASON",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "08005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1308450",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "43077",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1188102",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Belha-Schuler, PHARMD
• Jeremy Bell
• Mark Alan Bell, D.D.S.
• William Joseph Benevento, MD
• Sara Bennion, MS, MFT
• Kenton Benson
• Lenore Louise Benton-Bey
• Bergthold Chiropractic Inc
• Mark Jerome Bergthold, DC
• Bettendorf Community School District

• General Practice Dentistry in Bettendorf, IA
• Providers in Bettendorf, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.