Mark Benavides D.D.S., P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0019-20337 Issued in IL

Legal business name

MARK BENAVIDES D.D.S., P.C.

Practice address

1703 Polaris Cir
Ottawa, IL 61350-1683

Phone

(815) 434-0152

NPI assigned

Nov 14, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mark Benavides, D.D.S.

Title

Owner

Phone

(815) 434-0152

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387238400000",
    "number": "1235201344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 POLARIS CIR",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613501683",
            "telephone_number": "815-434-0152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 POLARIS CIR",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613501683",
            "telephone_number": "815-434-0152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK BENAVIDES D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2013-12-17",
        "status": "A",
        "authorized_official_last_name": "BENAVIDES",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-434-0152",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "0019-20337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Francis Mangold, ED.D.
• David O Manigold, MD
• Jessica Manijak, DPT
• Alejandro Marchini, M.D.
• Jordan Grace Marganski, MD
• Katie Marshall, APRN, CNM
• Austin David Martin, MD
• Martini Chiropractic, PLLC
• Brenda Ann Mason, LCPC
• Laura Linnea Mason, MPT

• General Practice Dentistry in Ottawa, IL
• Providers in Ottawa, 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 Dec 17, 2013; 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.