Active NPI
Jacqueline Fe Benito, DMD
- Dentist
- Sacramento, CA
National Provider Identifier
1396152138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 63602
- Practice address
- 1111 24TH St Ste 201
Sacramento, CA 95816-5019 - Phone
- (916) 442-5228
- NPI assigned
- Jul 14, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 63602 | CA | Primary |
Addresses
Primary practice location
1111 24TH St Ste 201
Sacramento, CA 95816-5019
Mailing address
8391 Quail Peak Court
Elk Grove, CA 95758
Phone (916) 806-9621
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 |
|---|---|---|---|
| 63602 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pro Dental Group | Dentist | Past | Accepting new patients |
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.
-
- Dentist
- Sacramento, CA
- NPI 1699925453
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405296000000",
"number": "1396152138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8391 QUAIL PEAK COURT",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "95758",
"telephone_number": "916-806-9621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 24TH ST STE 201",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958165019",
"telephone_number": "916-442-5228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FE BENITO",
"first_name": "JACQUELINE",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-14",
"last_updated": "2014-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "63602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.