Active NPI
Douglas T Bengson, DDS
- General Practice Dentistry
- Minot, ND
National Provider Identifier
1376752741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 1806
- Practice address
- 515 20TH Ave SE
Suite 8
Minot, ND 58701-6661 - Phone
- (701) 852-4755
- Fax
- (701) 852-8016
- NPI assigned
- May 22, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1806 | ND | Primary |
Addresses
Primary practice location
515 20TH Ave SE
Suite 8
Minot, ND 58701-6661
Mailing address
515 20TH Ave SE
Suite 8
Minot, ND 58701-6661
Phone (701) 852-4755
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 901806 | Other | ND | DENTAL SERVICE CORP |
| 41094 | Medicaid | ND |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1806 | ND | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dakota Dental Health Center | General Practice | Past | Accepting new patients |
| Dakota Dental Health Center PLLC | General Practice | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Minot, ND
- NPI 1619185824
-
- General Practice Dentistry
- Minot, ND
- NPI 1639414451
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376752741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 20TH AVE SE",
"address_2": "SUITE 8",
"city": "MINOT",
"state": "ND",
"postal_code": "587016661",
"telephone_number": "701-852-4755",
"fax_number": "701-852-8016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 20TH AVE SE",
"address_2": "SUITE 8",
"city": "MINOT",
"state": "ND",
"postal_code": "587016661",
"telephone_number": "701-852-4755",
"fax_number": "701-852-8016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENGSON",
"first_name": "DOUGLAS",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "ND",
"license": "1806",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL SERVICE CORP",
"identifier": "901806",
"state": "ND"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "41094",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minot, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.