Benjamin Campbell, D.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

6491-15 Issued in WI

Practice address

3136 Katie Ida LN
Sun Prairie, WI 53590-9273

Phone

(828) 572-8376

NPI assigned

Aug 19, 2006

Last updated

Jan 9, 2023By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Teledentistry Consulting LLC

  • Dental Clinic/Center
  • Cottonwood Heights, UT
  • NPI 1376101436
  NPD Authorized official

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1235243890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3136 KATIE IDA LN",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535909273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3136 KATIE IDA LN",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535909273",
            "telephone_number": "828-572-8376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1931 Main St",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543023920",
            "country_code": "US",
            "telephone_number": "833-225-0853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "021.002951",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WI",
            "license": "6491-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janet A Buzzell, R.N.
• By by Transportation
• Ann M Byrne, NP,APNP
• Robert L Cadwallader, D.C.
• Habibou Camara
• Elizabeth Canfield, MA, LPC
• Caring Made Easy Home Care LLC
• Kristin Carlson, PHARMD
• Robert J Carpenter, DDS
• Molly Elizabeth Carrell, AGPCNP-BC

• Orthodontics and Dentofacial Orthopedics Dentistry in Sun Prairie, WI
• Providers in Sun Prairie, WI by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; 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.