Active NPI
Benjamin Jeffrey Connor, D.D.S.
- General Practice Dentistry
- Washington, MO
National Provider Identifier
1396972501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2009013175
- Practice address
- 851 E 5TH St
Suite 200
Washington, MO 63090-3135 - Phone
- (636) 239-8585
- Fax
- (636) 239-8553
- NPI assigned
- Jun 15, 2009
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health Dentistry | 1223D0001X | 2009013175 | MO | |
| General Practice Dentistry | 1223G0001X | 2009013175 | MO | Primary |
Addresses
Primary practice location
851 E 5TH St
Suite 200
Washington, MO 63090-3135
Mailing address
PO Box 502852
Saint Louis, MO 63150-2852
Phone (636) 239-8585
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2009013175 | MO | MD | Public Health Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Hospitals East Communities | Current | Accepting new patients |
Locations
851 E 5th St
Ste 200
Washington, MO 63090
Phone (636) 239-8585
Interoperability endpoints
- bconnor373707@directc.mercy.net
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.
-
- Rural Health Clinic/Center
- Washington, MO
- NPI 1104912997
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776902400000",
"number": "1396972501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 502852",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631502852",
"telephone_number": "636-239-8585",
"fax_number": "636-239-8553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "851 E 5TH ST",
"address_2": "SUITE 200",
"city": "WASHINGTON",
"state": "MO",
"postal_code": "630903135",
"telephone_number": "636-239-8585",
"fax_number": "636-239-8553"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNOR",
"first_name": "BENJAMIN",
"middle_name": "JEFFREY",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-15",
"last_updated": "2026-04-23",
"certification_date": "2026-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223D0001X",
"taxonomy_group": "",
"desc": "Dentist, Dental Public Health",
"state": "MO",
"license": "2009013175",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MO",
"license": "2009013175",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.