Benjamin F. Tanner II DMD PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN013182 Issued in GA

Legal business name

BENJAMIN F. TANNER II DMD PC

Practice address

114 Huxford St
Homerville, GA 31634-2357

Phone

(912) 487-5271

Fax

(912) 487-5271

NPI assigned

Apr 19, 2010

Last updated

Apr 19, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Landon K Grantham

Title

Office Manager

Phone

(912) 487-5271

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Benjamin Franklin Tanner II, DMD

  • Dentist
  • Homerville, GA
  • NPI 1134325954
  NPD (past)

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

{
    "created_epoch": "1271635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271635200000",
    "number": "1437475209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 HUXFORD ST",
            "city": "HOMERVILLE",
            "state": "GA",
            "postal_code": "316342357",
            "telephone_number": "912-487-5271",
            "fax_number": "912-487-5271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 HUXFORD ST",
            "city": "HOMERVILLE",
            "state": "GA",
            "postal_code": "316342357",
            "telephone_number": "912-487-5271",
            "fax_number": "912-487-5271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENJAMIN F. TANNER II DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-19",
        "last_updated": "2010-04-19",
        "status": "A",
        "authorized_official_last_name": "GRANTHAM",
        "authorized_official_first_name": "LANDON",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "912-487-5271",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "827915201D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Homerville, GA
• Providers in Homerville, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.