Individual provider Active NPI

Benjamin Chiou

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Phoenix, AZ
National Provider Identifier
1447706122
Registry record updated Aug 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
D009583 Issued in AZ
Practice address
4803 E Ray Rd
P002C
Phoenix, AZ 85044-6496
Phone
(480) 755-4455
NPI assigned
Aug 31, 2016
Last updated
Aug 31, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X D009583 AZ Primary

Addresses

Primary practice location

4803 E Ray Rd
P002C
Phoenix, AZ 85044-6496

Mailing address

479 E Vinedo LN
Tempe, AZ 85284-1459
Phone (480) 246-6849

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161230001433 CA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 7416238639

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D009583AZMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
El Mirage Dental Partners LLC PastSince Feb 18, 2024 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472601600000",
    "number": "1447706122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "479 E VINEDO LN",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852841459",
            "telephone_number": "480-246-6849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4803 E RAY RD",
            "address_2": "P002C",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850446496",
            "telephone_number": "480-755-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIOU",
        "first_name": "BENJAMIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-31",
        "last_updated": "2016-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "AZ",
            "license": "D009583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.