Breanna Marjorie Benbow, DDS
Individual provider Active NPI Public Health Dentistry · Whiteville, NC
NPI 1376112433 · NPPES record last updated Jun 23, 2021
Key facts
- NPI
- 1376112433
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Public Health Dentistry 1223D0001X
- License
- 12218 (NC)
- Practice address
- 304 Jefferson St
Whiteville, NC 28472-3602 - Phone
- (910) 640-6615
- NPI assigned
- Jun 23, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12218 | NC | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12218 | NC | |
| General Practice Dentistry | 1223G0001X | 12218 | NC | |
| Public Health Dentistry | 1223D0001X | 12218 | NC | Yes |
Addresses
Primary practice location
304 Jefferson St
Whiteville, NC 28472-3602
Mailing address
PO Box 810
Whiteville, NC 28472-0810
Phone (910) 640-6615
Other providers in Whiteville, NC
- Talley Addison Barnhill
- Stephanie Denise Bates
- Hannah Leighann Battley
- Harrison B Baucom
- Behavioral Health of North Carolina, Inc.
- Rene Bermudez
- Devoria Keaton Berry
- Richard Garth Berry
- Better Primary Care and Wellness
- Elizabeth Erin Bickell
All providers in Whiteville, NC · Public Health Dentistry in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.