Roxanne Patricia Benison, DMD MS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

021-002093 Issued in IL

Practice address

22 Glen Ed Professional Park Ste B
Glen Carbon, IL 62034-3300

Phone

(618) 659-2030

Fax

(618) 659-2035

NPI assigned

Jul 17, 2006

Last updated

Oct 15, 2019By the provider in NPPES

Sex

Female

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 IL

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

Credentials

Master of Science

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.

• Signature Endodontics

  • Endodontics
  • Edwardsville, IL
  • NPI 1891976825
  NPD (past) Authorized official
• Endodontics of Edwardsville PLLC

  dba Signature Endodontics

  • Endodontics
  • Glen Carbon, IL
  • NPI 1487375549
  NPD

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1285651703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 GLEN ED PROFESSIONAL PARK B",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620343300",
            "telephone_number": "618-659-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 GLEN ED PROFESSIONAL PARK STE B",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620343300",
            "telephone_number": "618-659-2030",
            "fax_number": "618-659-2035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENISON",
        "first_name": "ROXANNE",
        "middle_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "DMD MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IL",
            "license": "021-002093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Bauer Hite, DMD MS
• Joachim O Bauer, D.D.S., M.S.
• Bauerhite Orthodontic Specialists, PC
• Rodolfo Scott Beer, MD
• Alexis Marie Belfiore, RBT
• Lauren Elizabeth Berkenbile
• Craig A Beyer, MD
• Charles G Bishop Jr., MD
• BJC Home Care Services (BJC Hospice)
• Kyle John Blievernicht, MOT

• Endodontics in Glen Carbon, IL
• Providers in Glen Carbon, IL by specialty
• Endodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; 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.