Benjamin Quenzer Richardson, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.035650 Issued in IL

Practice address

95 S Waukegan Rd
Deerfield, IL 60015-5204

Phone

(224) 515-7390

NPI assigned

May 25, 2021

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

Practice roles

Locations

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.

• Dental Professionals of Illinois, P.C.

  • General Practice Dentistry
  • Deerfield, IL
  • NPI 1013632801
  NPD

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735948800000",
    "number": "1164097770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 W NORTH AVE APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221335",
            "telephone_number": "812-550-4391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 S WAUKEGAN RD",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600155204",
            "telephone_number": "224-515-7390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "BENJAMIN",
        "middle_name": "QUENZER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-25",
        "last_updated": "2025-01-04",
        "certification_date": "2025-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.035650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Renihan, RBT
• Mayra Sugey Reyna Ceballos
• Margaret Reynolds
• Jennifer Riback, CCC/SLP
• Stephanie Ricedorf
• Andrea Ridgway, PH.D, BCBA-D
• Unknown Riya
• RN Counseling PLLC
• Jamie L Roberts
• Lisa Robin

• General Practice Dentistry in Deerfield, IL
• Providers in Deerfield, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2025; 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.