Vincent Vern Benivegna, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2901015585 Issued in MI

Practice address

325 W Lake Lansing Rd
East Lansing, MI 48823-8524

Phone

(517) 337-9759

Fax

(517) 337-8156

NPI assigned

Sep 9, 2005

Last updated

Oct 26, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Mid Michigan Oral Surgery PC

  • Oral and Maxillofacial Surgery (Dentist)
  • East Lansing, MI
  • NPI 1174516413
  Medicare reassignment NPD Authorized official
• Mid Michigan Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Charlotte, MI
  • NPI 1861650095
  NPD

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1326032988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 W LAKE LANSING RD",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488238524",
            "telephone_number": "517-337-9759",
            "fax_number": "517-337-8156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 W LAKE LANSING RD",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488238524",
            "telephone_number": "517-337-9759",
            "fax_number": "517-337-8156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENIVEGNA",
        "first_name": "VINCENT",
        "middle_name": "VERN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901015585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10-3360161",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Camryn Johanna Bekkering
• James Bellar
• David Bellefleur
• Alison Bellestri
• Victoria Bender
• Benjamin S. Jamo DDS, PLLC (Benjamin S. Jamo DDS)
• Bennett Optometry LLC (Clarkson Eyecare)
• Bennett Optometry LLC (Clarkson Eyecare)
• Bennett Optometry LLC (Clarkson Eyecare)
• Audrey Bennett, OTR/L

• Oral and Maxillofacial Surgery (Dentist) in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; 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.