Benso Gold Dental, P.a.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BENSO GOLD DENTAL, P.A.

Practice address

571 S 6TH St
Macclenny, FL 32063-2605

Phone

(904) 653-3333

Fax

(904) 653-3333

NPI assigned

Jul 29, 2025

Last updated

Aug 5, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

BENSO GOLD DENTAL, P.A.As reported in NPPES

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

Authorized official

Name

Derrick Carter, DMDNPI 1063508208

Title

Dentist/Owner

Phone

(904) 653-3333

Specialties & licenses 1

Addresses

Part of

Benso Gold Dental PA

Locations

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.

• Derrick Gene Carter, D.M.D.

  • General Practice Dentistry
  • Macclenny, FL
  • NPI 1063508208
  NPD (past) Authorized official

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

{
    "created_epoch": "1753747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754352000000",
    "number": "1306729181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 S 6TH ST",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320632605",
            "telephone_number": "904-653-3333",
            "fax_number": "904-653-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "571 S 6TH ST",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320632605",
            "telephone_number": "904-653-3333",
            "fax_number": "904-653-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENSO GOLD DENTAL, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BENSO GOLD DENTAL, P.A.",
        "enumeration_date": "2025-07-29",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "904-653-3333",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latoya D Barnes, APRN
• Aron Croslin Bell, LMHC
• Samitria Latrice Bell
• Deborah Lynn Bellino, APRN
• Alexcia Bennett
• Bio-Medical Applications of Florida, Inc. (Fresenius Medical Care Macclenny)
• Amanda Jean Bondie
• Janie Boulware
• Tiffany Faye Braddy, APRN
• Johnnie N Bradley-Goodman, APRN, PMHNP - BC

• Dental Clinic/Center in Macclenny, FL
• Providers in Macclenny, FL by specialty
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; 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.