Active NPI
Benjamin Mithrandir Magleby
- General Practice Dentistry
- Jacksonville, NC
National Provider Identifier
1093785222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 53828
- Practice address
- 142 Plow Point LN
Jacksonville, NC 28546-9591 - Phone
- (650) 305-9922
- NPI assigned
- Jan 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 53828 | CA | Primary |
Addresses
Primary practice location
142 Plow Point LN
Jacksonville, NC 28546-9591
Mailing address
142 Plow Point LN
Jacksonville, NC 28546-9591
Phone (650) 305-9922
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211155200000",
"number": "1093785222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "142 PLOW POINT LN",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285469591",
"telephone_number": "650-305-9922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "142 PLOW POINT LN",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285469591",
"telephone_number": "650-305-9922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAGLEBY",
"first_name": "BENJAMIN",
"middle_name": "MITHRANDIR",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-23",
"last_updated": "2008-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "53828",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.