Kenneth J. Benson, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

6621 Issued in NC

Practice address

7401 Creedmoor Rd
Raleigh, NC 27613-1640

Phone

(919) 622-2035

Fax

(919) 846-3550

NPI assigned

May 13, 2006

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 30, 2017 through Nov 30, 2027

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Kenneth J. Benson, DDS

  • Oral and Maxillofacial Pathology Dentistry
  • Apex, NC
  • NPI 1205930765
  NPD (past) Authorized official
• Macon, Collie, Pretzer, Kornstein and Hicks DDS

  dba Wake Orthodontics & Pediatric Dentistry

  • Pediatric Dentistry
  • Raleigh, NC
  • NPI 1306894597
  NPD

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1326099458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7401 CREEDMOOR RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276131640",
            "telephone_number": "919-622-2035",
            "fax_number": "919-846-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7401 CREEDMOOR RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276131640",
            "telephone_number": "919-622-2035",
            "fax_number": "919-846-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENSON",
        "first_name": "KENNETH",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "6621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "6621",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89022VT",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "902VT",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hollon Skinner Benson, MSW, LCSW
• Jill L Benson, MD
• John Dewitt Benson, MD
• Kara Beth Benson, PTA
• Kemayaa Lade'Ja Benson
• William Alexander Benson IV, DDS
• Yeshira Sheneese Benson, LMFT-A
• Kayleigh M Bentham, MS, OTR/L
• Alexandra Denise Bentley, M.D.
• Lindsay Sawyer Bentley, PHYSICIAN ASSISTANT

• Oral and Maxillofacial Surgery (Dentist) in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Oral and Maxillofacial Surgery (Dentist) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.