Individual provider Active NPI

Benjamin Max Stein, DDS

  • General Practice Dentistry
  • Minneapolis, MN
National Provider Identifier
1265896864
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019.031066 Issued in IL
Practice address
230 Broadway St NE
Minneapolis, MN 55413-1902
Phone
(952) 212-0647
NPI assigned
Apr 9, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019.031066 IL Primary

Addresses

Primary practice location

230 Broadway St NE
Minneapolis, MN 55413-1902

Mailing address

100 3Rd Ave S Unit 701
Minneapolis, MN 55401-2703
Phone (952) 212-0647

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Previously, effective Aug 24, 2020 through Aug 24, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.031066ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
BMS Dental CurrentSince Oct 8, 2023 Accepting new patients
Webster Dental Care Sauganash, LTD General Practice PastSince Jul 24, 2022 Accepting new patients
World Class Smiles Chicago General Practice PastSince Jul 24, 2022 Accepting new patients
Snoring and Sleep Apnea Dental Treatment Center General Practice Past Accepting new patients

Locations

230 Broadway St NE
Minneapolis, MN 55413
Phone (612) 379-2300

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1460160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1265896864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 3RD AVE S UNIT 701",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554012703",
            "telephone_number": "952-212-0647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 BROADWAY ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131902",
            "telephone_number": "952-212-0647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEIN",
        "first_name": "BENJAMIN",
        "middle_name": "MAX",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-09",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.031066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.