Brian Douglas Benjamin, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

24215 Issued in CA

Practice address

2123 Avenida Espada
San Clemente, CA 92673-5608

Phone

(714) 478-9849

NPI assigned

Apr 12, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246320000000",
    "number": "1356565477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2123 AVENIDA ESPADA",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926735608",
            "telephone_number": "714-478-9849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2123 AVENIDA ESPADA",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926735608",
            "telephone_number": "714-478-9849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "BRIAN",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2009-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "24215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Beaubier Tillotson, LMT
• Joshua Lawrence Beauchaine, LMFT
• Engy Bebaway, PHARM.D.
• Faith Elizabeth Bechtel
• Gwendolyn Bellezza, M.A., CCC-SLP
• Criag R Bergquist, DDS
• Kelly Bermingham, MA
• Brianna Bern
• Miki Bernal, MA, OT/L, CHT
• Edward Horacio Bestard, M.D., F.A.C.S.

• General Practice Dentistry in San Clemente, CA
• Providers in San Clemente, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; 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.