Benjamin Jarvis Passey, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

112964 Issued in CA

Practice address

4212 Missouri Flat Rd
Placerville, CA 95667-6269

Phone

(530) 621-7700

Fax

(530) 621-7713

NPI assigned

May 22, 2026

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1779408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1124958798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13325 S ENSIGN POINT LN APT 6204",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840208002",
            "telephone_number": "208-803-8613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 MISSOURI FLAT RD",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956676269",
            "telephone_number": "530-621-7700",
            "fax_number": "530-621-7713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASSEY",
        "first_name": "BENJAMIN",
        "middle_name": "JARVIS",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-05-22",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "112964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marvin F Parker, CAS I
• Roberta Diane Parker, CADC LL
• Amy Lynn Parsons, RN
• Malini Parthasarathi, PT
• Ruth Pascale-Jones, LMFT
• Sean Patterson, D.C.
• Alison Payne, MS,CCC/SLP
• L. Mark Payne, M.S.
• Robert John Payne, R.PH
• Mehri Pazeky, ED.S,

• General Practice Dentistry in Placerville, CA
• Providers in Placerville, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; 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.