Individual provider Active NPI

Shawn Benso, DDS

  • General Practice Dentistry
  • Phoenix, AZ
National Provider Identifier
1366644387
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6691 Issued in AZ
Practice address
2501 W Happy Valley Rd Ste 52-1310
Phoenix, AZ 85085-3704
Phone
(623) 582-5999
Fax
(623) 780-7515
NPI assigned
Jun 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 6691 AZ Primary

Addresses

Primary practice location

2501 W Happy Valley Rd Ste 52-1310
Phoenix, AZ 85085-3704

Mailing address

2501 W Happy Valley Rd Ste 52-1310
Phoenix, AZ 85085-3704
Phone (623) 582-5999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160526000543 AZ Order and Referring Only - DentistPractitioner - Dentist 0547550972

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6691AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Shawn Benso DDS PLLC General Practice CurrentSince May 18, 2025 Accepting new patients

Locations

2501 W Happy Valley Rd
Ste 521310
Phoenix, AZ 85085
Phone (623) 582-5999

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1366644387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 W HAPPY VALLEY RD STE 52-1310",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850853704",
            "telephone_number": "623-582-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 W HAPPY VALLEY RD STE 52-1310",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850853704",
            "telephone_number": "623-582-5999",
            "fax_number": "623-780-7515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENSO",
        "first_name": "SHAWN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-01",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "6691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.