Nicholas Dennis Beneda, DDS

Individual provider Active NPI General Practice Dentistry · Park River, ND

NPI 1295938504 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1295938504
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2003 (ND)
Practice address
418 Briggs Ave S
Park River, ND 58270-0662
Phone
(701) 284-6201
Fax
(701) 284-6901
NPI assigned
Jun 6, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2003NDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Park River Dental, PC General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2003 ND Yes

Addresses

Primary practice location

418 Briggs Ave S
Park River, ND 58270-0662

Mailing address

PO Box 662
418 Briggs Ave
Park River, ND 58270-0662
Phone (701) 284-6201

Other providers in Park River, ND

All providers in Park River, ND · General Practice Dentistry in North Dakota

Sources for this page

Verify at the official NPI Registry.