Ebby Prime, LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

EBBY PRIME, LLC

Practice address

390 N Bell PL
Chandler, AZ 85225-4200

Phone

(602) 568-8116

NPI assigned

Aug 3, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Brett E Benson, DDS

Title

Manager

Phone

(602) 545-8400

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1343952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343952000000",
    "number": "1043566466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "652 E WARNER RD",
            "address_2": "STE 101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852963071",
            "telephone_number": "602-568-8116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 N BELL PL",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852254200",
            "telephone_number": "602-568-8116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBBY PRIME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-03",
        "last_updated": "2012-08-03",
        "status": "A",
        "authorized_official_last_name": "BENSON",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "602-545-8400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2012; 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.