Benton James Runquist, D.D.S., M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

33843 Issued in CA

Practice address

635 Anderson Rd
Suite #6
Davis, CA 95616-3505

Phone

(530) 756-0220

Fax

(530) 758-3796

NPI assigned

Oct 31, 2006

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063598167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 GRANDE AVE",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956160211",
            "telephone_number": "530-757-6780",
            "fax_number": "530-758-3796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 ANDERSON RD",
            "address_2": "SUITE #6",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956163505",
            "telephone_number": "530-756-0220",
            "fax_number": "530-758-3796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNQUIST",
        "first_name": "BENTON",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "33843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hali Rowen, PH.D.
• Dulce M Ruatti, LCSW
• Isabel Brianna Rubalcaba
• Barbara Rudell
• Byron Ruiz, DDS
• Ashton Rushing
• Lauren Victoria Russell-Smith, FNP
• Michael Corey Russell
• Uta Russell, LCSW
• Amber Rutledge, MA, AMFT

• Orthodontics and Dentofacial Orthopedics Dentistry in Davis, CA
• Providers in Davis, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.