Individual provider Active NPI

William Lane Benedetti, D.M.D.

  • Dentist
  • McKeesport, PA
National Provider Identifier
1245486448
Registry record updated Aug 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
PA-020258-L Issued in PA
Practice address
726 Long Run Rd.
McKeesport, PA 15132
Phone
(412) 751-0922
NPI assigned
Aug 7, 2008
Last updated
Aug 7, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X PA-020258-L PA Primary

Addresses

Primary practice location

726 Long Run Rd.
McKeesport, PA 15132

Mailing address

726 Long Run Rd.
McKeesport, PA 15132
Phone (412) 751-0922

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20160602001523 PA Order and Referring Only - DentistPractitioner - Dentist 8628368776

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA-020258-LPAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1218067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218067200000",
    "number": "1245486448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 LONG RUN RD.",
            "city": "MCKEESPORT",
            "state": "PA",
            "postal_code": "15132",
            "telephone_number": "412-751-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 LONG RUN RD.",
            "city": "MCKEESPORT",
            "state": "PA",
            "postal_code": "15132",
            "telephone_number": "412-751-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENEDETTI",
        "first_name": "WILLIAM",
        "middle_name": "LANE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-07",
        "last_updated": "2008-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "PA-020258-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKeesport, PA

Sources for this page

Verify at the official NPI Registry.