Benjamin Koren, D.D.S. III. P.a,

Primary specialty

DentistTaxonomy code 122300000X

License

6997 Issued in NC

Legal business name

BENJAMIN KOREN, D.D.S. III. P.A,

Doing business as

Creedmoor Family Dentistry

Practice address

110 W Church St
Creedmoor, NC 27522-9747

Phone

(919) 528-4004

Fax

(919) 528-2211

NPI assigned

Jul 5, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Benjamin Victor Koren, DDS

Title

Owner

Phone

(919) 528-4004

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Creedmoor Family Dentistry Doing business as

Practitioners 2

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.

• Aaron Scott Hewett, DMD

  • Dentist
  • Creedmoor, NC
  • NPI 1407001076
  NPD (past)
• Matthew Henrichsen Willis, D.D.S

  • General Practice Dentistry
  • Creedmoor, NC
  • NPI 1861749665
  NPD (past)

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336170042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W CHURCH ST",
            "city": "CREEDMOOR",
            "state": "NC",
            "postal_code": "275229747",
            "telephone_number": "919-528-4004",
            "fax_number": "919-528-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W CHURCH ST",
            "city": "CREEDMOOR",
            "state": "NC",
            "postal_code": "275229747",
            "telephone_number": "919-528-4004",
            "fax_number": "919-528-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENJAMIN KOREN, D.D.S. III. P.A,",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOREN",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "VICTOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-528-4004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "6997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "017JW",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5902042",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creedmoor Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Beatrice Awe
• Elizabeth Beatrice Baltaro, MD
• Syam Bandi
• Christina O Beck, M.D.
• Stephanie Beck
• Meldrina A. Bernard
• Yvonne E Berstler, MD
• Best Care Pharmacy of Creedmoor, L.L.C.
• Bip - Behavior Intervention Professionals of the Triangle, PLLC
• Stephanie Black

• Dentist in Creedmoor, NC
• Providers in Creedmoor, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.