Kevin Benjumea

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

062485 Issued in NY

Practice address

760 Broadway
Brooklyn, NY 11206-5317

Phone

(646) 249-4121

NPI assigned

Feb 12, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• Growing Smiles Pediatric Dentistry PLLC

  • Pediatric Dentistry
  • New Hyde Park, NY
  • NPI 1699507517
  NPD Authorized official

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

{
    "created_epoch": "1581465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1154953685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8819 242ND ST",
            "city": "BELLEROSE",
            "state": "NY",
            "postal_code": "114261240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 BROADWAY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112065317",
            "telephone_number": "646-249-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJUMEA",
        "first_name": "KEVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-12",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "062485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rose Astrid Benjamin
• Shonell Ann Benjamin, PT, DPT
• Stephanie Benjamin, LMSW
• Taisha Lashon Benjamin, M.D.
• Trisha Maria Benjamin, PT, DPT
• Mark M Benkel, MD
• Maha Benkirane, LMHC LP
• Una May Benloss
• Cherrisse Benn I
• Diedre Gail Benn

• Pediatric Dentistry in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.