Charles Michael Bennett, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

375815 Issued in UT

Practice address

812 S State St
Orem, UT 84097-7026

Phone

(801) 691-0457

Fax

(801) 691-1232

NPI assigned

Dec 6, 2006

Last updated

Jun 3, 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Networks

• UT PPO D-SNP

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• TMJ & Sleep Therapy Centre of Utah

  • Dentist
  • Orem, UT
  • NPI 1710233887
  Authorized official Same address or phone

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464912000000",
    "number": "1225197577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 S STATE ST",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840977026",
            "telephone_number": "801-360-0981",
            "fax_number": "801-691-1232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 S STATE ST",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840977026",
            "telephone_number": "801-691-0457",
            "fax_number": "801-691-1232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "CHARLES",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2016-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "375815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yamileth Beltran Medrano
• Davis Bench, BCBA
• Braian Benitez
• Alexandria Bennett
• Brooke Ellen Bennett
• Sam Bennett, MFT
• Karla Bennion, PH.D.
• Kristin Bennion, LCSW
• Mary Bennion
• Olivia Benshoff, BT

• General Practice Dentistry in Orem, UT
• Providers in Orem, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2016; 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.