Individual provider Active NPI

Ben A Sircus, DDS

  • General Practice Dentistry
  • Glen Burnie, MD
National Provider Identifier
1467645176
Registry record updated Aug 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12538 Issued in MD
Practice address
7836 Oakwood Rd
Suite B
Glen Burnie, MD 21061-4244
Phone
(410) 766-4650
NPI assigned
Aug 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12538 MD Primary

Addresses

Primary practice location

7836 Oakwood Rd
Suite B
Glen Burnie, MD 21061-4244

Mailing address

7836 Oakwood Rd
Suite B
Glen Burnie, MD 21061-4244
Phone (410) 766-4650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20150710001394 MD Order and Referring Only - DentistPractitioner - Dentist 2365754967

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12538MDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Nuger & Sircus DDS, PA General Practice Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188172800000",
    "number": "1467645176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7836 OAKWOOD RD",
            "address_2": "SUITE B",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614244",
            "telephone_number": "410-766-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7836 OAKWOOD RD",
            "address_2": "SUITE B",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614244",
            "telephone_number": "410-766-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRCUS",
        "first_name": "BEN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-27",
        "last_updated": "2007-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "12538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.