Benjamin Robert Squires, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

08553 Issued in IA

Practice address

3308 Kimball Ave
Waterloo, IA 50702-5758

Phone

(319) 233-6177

NPI assigned

Jun 23, 2008

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

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Benjamin R. Squires, D.D.S.

  • General Practice Dentistry
  • Waterloo, IA
  • NPI 1477225845
  NPD (past) Authorized official

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1235390295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3308 KIMBALL AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025758",
            "telephone_number": "319-233-6177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3308 KIMBALL AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025758",
            "telephone_number": "319-233-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SQUIRES",
        "first_name": "BENJAMIN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-23",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "08553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Kent Spragg, DDS
• Thomas R Spragg, MD
• Carla J Springer, M.D.
• Jane A. Springer, PHD
• Eric Spurgeon, DDS
• Kathryn Squires, RD, LD
• Gail Stachovic, BS PHARM, R. PH.
• Lindsay Stack, LMHC, CADC
• Stacy C Wilson LMHC PLC
• Bethany Stafford

• General Practice Dentistry in Waterloo, IA
• Providers in Waterloo, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.