Active NPI
Benjamin James Patterson, DDS
- Dentist
- Eagan, MN
National Provider Identifier
1215667852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D14768
- Practice address
- 1895 Plaza Dr Ste 130
Eagan, MN 55122-4601 - Phone
- (651) 454-2700
- NPI assigned
- Jun 15, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D14768 | MN | Primary |
Addresses
Primary practice location
1895 Plaza Dr Ste 130
Eagan, MN 55122-4601
Mailing address
3735 Rhode Island Ave S
Minneapolis, MN 55426-4344
Phone (507) 226-1474
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D14768 | MN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PDG, P.a. | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655251200000",
"number": "1215667852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3735 RHODE ISLAND AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554264344",
"telephone_number": "507-226-1474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1895 PLAZA DR STE 130",
"city": "EAGAN",
"state": "MN",
"postal_code": "551224601",
"telephone_number": "651-454-2700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTERSON",
"first_name": "BENJAMIN",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-06-15",
"last_updated": "2022-06-15",
"certification_date": "2022-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D14768",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eagan, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.