Bennington Dental Center PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0160073365 Issued in VT

Legal business name

BENNINGTON DENTAL CENTER PC

Practice address

219 River St
Bennington, VT 05201-1834

Phone

(802) 442-9500

NPI assigned

Sep 29, 2011

Last updated

Mar 17, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Tyler J Carmack, DMDNPI 1538390042

Title

Owner

Phone

(802) 442-9500

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tyler Carmack, D.M.D.

  • General Practice Dentistry
  • Shaftsbury, VT
  • NPI 1538390042
  NPD (past) Authorized official
• Robert J Miller, D.D.S.

  • General Practice Dentistry
  • Bennington, VT
  • NPI 1447270525
  NPD (past)

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

{
    "created_epoch": "1317254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1104100841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 RIVER ST",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052011834",
            "telephone_number": "802-442-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 RIVER ST",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052011834",
            "telephone_number": "802-442-9500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "129 Elm St",
            "address_purpose": "LOCATION",
            "city": "Bennington",
            "state": "VT",
            "postal_code": "052012249",
            "country_code": "US",
            "telephone_number": "802-442-9500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BENNINGTON DENTAL CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-29",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "CARMACK",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "802-442-9500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "VT",
            "license": "0160073365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Bennington, VT
• Providers in Bennington, VT by specialty
• General Practice Dentistry in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.