Individual provider Active NPI

Zachary Bennett

  • General Practice Dentistry
  • Ann Arbor, MI
National Provider Identifier
1366029530
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2951000839 Issued in MI
Practice address
1011 N University Ave
Ann Arbor, MI 48109-1078
Phone
(734) 764-1523
Fax
(734) 615-7294
NPI assigned
Mar 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2951000839 MI Primary

Addresses

Primary practice location

1011 N University Ave
Ann Arbor, MI 48109-1078

Mailing address

1011 N University Ave
Ann Arbor, MI 48109-1078
Phone (734) 764-1523

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2951000839MIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1366029530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 N UNIVERSITY AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481091078",
            "telephone_number": "734-764-1523",
            "fax_number": "734-615-7294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 N UNIVERSITY AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481091078",
            "telephone_number": "734-764-1523",
            "fax_number": "734-615-7294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "ZACHARY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-25",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2951000839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; 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.