Fred Benzenhafer, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN21907 Issued in FL

Practice address

4045 Tyrone Blvd N
St Petersburg, FL 33709-4118

Phone

(727) 547-3491

NPI assigned

Jun 14, 2016

Last updated

Jun 14, 2016By the provider in NPPES

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 FL

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

State licenses

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1205286028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 TYRONE BLVD N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337094118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 TYRONE BLVD N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337094118",
            "telephone_number": "727-547-3491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENZENHAFER",
        "first_name": "FRED",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-14",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN21907",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN21907",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Ribner Benson, DPT
• Joy Benson, LMHC
• Michael J Bentley Jr.
• Erik J Benton, MD
• Vanessa Benzan-Monteiro, LICSW
• James M Benzschawel, DC
• Debra Berard, RN
• Valbona Berberi, APRN
• Berc Sarafian P a
• April Berger, PHD

• Dentist in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; 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.