Theodore Benaderet, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

18786 Issued in CA

Practice address

9900 McFadden Ave Ste 201
Westminster, CA 92683-6978

Phone

(714) 531-2513

Fax

(714) 531-1603

NPI assigned

Nov 28, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ted Benaderet Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124194394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 MCFADDEN AVE STE 201",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926836978",
            "telephone_number": "714-531-2513",
            "fax_number": "714-531-1603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 MCFADDEN AVE STE 201",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926836978",
            "telephone_number": "714-531-2513",
            "fax_number": "714-531-1603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENADERET",
        "first_name": "THEODORE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "18786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL (CALIFORNIA)",
            "identifier": "B18786-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TED",
            "last_name": "BENADERET",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Westminster, CA
• Providers in Westminster, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.