Individual provider Active NPI

Brooke Denise Benson, D.D.S.

  • Endodontics
  • Chicago, IL
National Provider Identifier
1073774816
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
019025055 Issued in IL
Practice address
700 S Clinton St
#202
Chicago, IL 60607-4350
Phone
(312) 353-4140
Fax
(312) 353-4180
NPI assigned
Jun 24, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 019025055 IL Primary

Addresses

Primary practice location

700 S Clinton St
#202
Chicago, IL 60607-4350

Mailing address

700 S Clinton St
#202
Chicago, IL 60607-4350
Phone (312) 353-4140

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

LicenseStateTypeSpecialty
019025055ILMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214265600000",
    "number": "1073774816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S CLINTON ST",
            "address_2": "#202",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074350",
            "telephone_number": "312-353-4140",
            "fax_number": "312-353-4180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S CLINTON ST",
            "address_2": "#202",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074350",
            "telephone_number": "312-353-4140",
            "fax_number": "312-353-4180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENSON",
        "first_name": "BROOKE",
        "middle_name": "DENISE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-24",
        "last_updated": "2008-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IL",
            "license": "019025055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; 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.