King Benjamin Dental PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

KING BENJAMIN DENTAL PLLC

Practice address

3467 Pine Ridge Rd Ste 101
Naples, FL 34109-3832

Phone

(239) 251-5045

NPI assigned

Oct 11, 2024

Last updated

Oct 11, 2024By 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

Bradly MouritsenNPI 1366978082

Title

Sole Member

Phone

(239) 251-5045

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Bradly James Mouritsen, DMD

  • Dentist
  • Naples, FL
  • NPI 1366978082
  NPD Authorized official

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

{
    "created_epoch": "1728604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728604800000",
    "number": "1366262701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18589 SARASOTA RD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339673520",
            "telephone_number": "239-240-5886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3467 PINE RIDGE RD STE 101",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341093832",
            "telephone_number": "239-251-5045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING BENJAMIN DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-11",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A",
        "authorized_official_last_name": "MOURITSEN",
        "authorized_official_first_name": "BRADLY",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "239-251-5045"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Christopher Kimmerly, DPT
• Susan Ruth Kimper, PMHNP-BC
• Terrence P Kimper, PH.D.
• James Kinderknecht, M.D.
• Kinetic Physical Therapy PA
• Linell Clinton King, MD
• Shawn M. King, FNP-BC
• Sonya Brielle King
• Terry A King
• King's Medical LLC

• Dentist in Naples, FL
• Providers in Naples, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; 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.