Benjamin Shirley , DDS, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0543381 Issued in NY

Legal business name

BENJAMIN SHIRLEY , DDS, PC

Practice address

992 Columbus Ave
New York, NY 10025-2501

Phone

(917) 667-6015

NPI assigned

Sep 30, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Benjamin Banneker Shirley I, D.D.S.

Title

Dentist

Phone

(917) 667-6015

Specialties & licenses 1

Addresses

Other names 1

• upper westside deantal Doing business as

Locations

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

{
    "created_epoch": "1317340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317340800000",
    "number": "1073897609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "992 COLUMBUS AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100252501",
            "telephone_number": "917-667-6015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "992 COLUMBUS AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100252501",
            "telephone_number": "917-667-6015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENJAMIN SHIRLEY , DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-30",
        "last_updated": "2011-09-30",
        "status": "A",
        "authorized_official_last_name": "SHIRLEY",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "BANNEKER",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "917-667-6015",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "I",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "0543381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "upper westside deantal",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in New York, NY
• Providers in New York, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; 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.