Benjamin J Gardner, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

D008660 Issued in AZ

Practice address

500 N Indiana Ave
Winslow, AZ 86047

Phone

(928) 289-6226

NPI assigned

Jun 12, 2013

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 12, 2013.

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1457799488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4255 E SOLIERE AVE APT 215",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860047930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N INDIANA AVE",
            "city": "WINSLOW",
            "state": "AZ",
            "postal_code": "86047",
            "telephone_number": "928-289-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "BENJAMIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-12",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D008660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Veronica Fuson, RN
• Melanie Gable, RN
• Janelle Dawn Gaddis, NP-C
• Rosa Idalia Gallegos, CPHT
• Gardner Dental LLC
• Brent Jacob Gardner, DDS
• Merih Estifanos Gebrezgiabher
• Gentle Soles, Inc.
• Juliette Gonzalez
• Teresa Gonzalez, M.A.

• All providers in Winslow, AZ
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; 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.