Active NPI
Benjamin W Harrelson, DMD
- Dentist
- Columbus, MS
National Provider Identifier
1124035811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 325403
- Practice address
- 540 Willowbrook Rd
Columbus, MS 39705 - Phone
- (662) 327-4523
- Fax
- (662) 327-1391
- NPI assigned
- Aug 2, 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 325403 | MS | Primary |
Addresses
Primary practice location
540 Willowbrook Rd
Columbus, MS 39705
Mailing address
540 Willowbrook Rd
Columbus, MS 39705
Phone (662) 327-4523
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective May 14, 2015 through May 14, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 325403 | MS | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nobles & Harrelson Dentistry Partnership | Dentist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Columbus, MS
- NPI 1013932920
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124035811",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "540 WILLOWBROOK RD",
"city": "COLUMBUS",
"state": "MS",
"postal_code": "39705",
"telephone_number": "662-327-4523",
"fax_number": "662-327-1391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "540 WILLOWBROOK RD",
"city": "COLUMBUS",
"state": "MS",
"postal_code": "39705",
"telephone_number": "662-327-4523",
"fax_number": "662-327-1391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRELSON",
"first_name": "BENJAMIN",
"middle_name": "W",
"name_prefix": "Mr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MS",
"license": "325403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, MS
Sources for this page
- 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.