Mario Benavente, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

35677 Issued in CA

Practice address

298 Linden Ave
San Bruno, CA 94066-4805

Phone

(650) 589-0494

NPI assigned

Aug 7, 2006

Sex

Male

Sole proprietor

Yes

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": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225047327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "298 LINDEN AVE",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940664805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 LINDEN AVE",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940664805",
            "telephone_number": "650-589-0494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENAVENTE",
        "first_name": "MARIO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "35677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bay Area PL Services
• Bayhill Acupuncture Health Center, Inc
• Kristina Marie Becker
• Madelline Beckham
• Laurie Bell, LMFT
• Dylan Kimora Benitez
• Graciela Andrea Benitez
• Genesys Bennett
• Kathleen Yvonne Bennett, LCSW
• Jesse Benz

• General Practice Dentistry in San Bruno, CA
• Providers in San Bruno, 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 Jul 8, 2007; 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.