NPIMap

Organization Active NPI

Benjamin Corey

  • Dental Clinic/Center
  • Hacienda Heights, CA
National Provider Identifier
1285038950
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
BENJAMIN COREY
Doing business as
Benjamin Corey
Practice address
17120 Ridge Park Dr
Hacienda Heights, CA 91745
Phone
(626) 755-0003
NPI assigned
Oct 9, 2014
Last updated
Mar 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

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

Authorized official

Name
Benjamin Fredric CoreyNPI 1144518754
Title
Owner
Phone
(626) 755-0003

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary
Counselor 101Y00000X

Addresses

Primary practice location

17120 Ridge Park Dr
Hacienda Heights, CA 91745

Mailing address

65 Pine Ave # 360
Long Beach, CA 90802-4718
Phone (626) 755-0003

Other identifiers 1

IdentifierTypeStateIssuer
RW8585OtherCACCBADC

Other names 1

  • Benjamin Corey Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Benjamin Corey2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1412812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615852800000",
    "number": "1285038950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 PINE AVE # 360",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024718",
            "telephone_number": "626-755-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17120 RIDGE PARK DR",
            "city": "HACIENDA HEIGHTS",
            "state": "CA",
            "postal_code": "91745",
            "telephone_number": "626-755-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENJAMIN COREY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-09",
        "last_updated": "2021-03-16",
        "certification_date": "2021-02-22",
        "status": "A",
        "authorized_official_last_name": "COREY",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "FREDRIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-755-0003"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCBADC",
            "identifier": "RW8585",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Benjamin Corey",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hacienda Heights, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; 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.