Benjamin Atlas, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12691 Issued in NC

Practice address

100 Brewster Blvd
Camp Lejeune, NC 28547-2575

Phone

(760) 519-4801

NPI assigned

Aug 21, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Atlas Dental LLC

  • Dental Clinic/Center
  • Sparks, NV
  • NPI 1821802448
  NPD Authorized official

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

{
    "created_epoch": "1503273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1457877458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921345000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472575",
            "telephone_number": "760-519-4801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Navy Medical Ctr",
            "address_2": "34800 Bob Wilson Drive",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921345000",
            "country_code": "US",
            "telephone_number": "619-532-6400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "36014 Wratten Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Hood",
            "state": "TX",
            "postal_code": "76544",
            "country_code": "US",
            "telephone_number": "760-519-4801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ATLAS",
        "first_name": "BENJAMIN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-21",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS101670",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "12691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "VAD0000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Ash
• Diana Ashe, MSW, LCSW
• Isabella Asimacopoulos, ATC
• Roy Atallah, IDC
• Arriel E Atienza, D.O.
• Eric Aul, IDC
• Glenda Aultowski, R.N.
• Nicholas Aures, RD
• David Frank Aurigemma, M.D.
• David Sullivan Axford, DO

• All providers in Camp Lejeune, NC
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; 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.

Verify at the official NPI Registry.