Ben Ottoson

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

30.025584 Issued in OH

Practice address

36000 Shoemaker Lane
Suite 1051
Fort Hood, TX 76544

Phone

(254) 286-7402

NPI assigned

Sep 19, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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.

{
    "created_epoch": "1537315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1467936120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36000 SHOEMAKER LANE",
            "address_2": "SUITE 1051",
            "city": "FORT HOOD",
            "state": "TX",
            "postal_code": "76544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36000 SHOEMAKER LANE",
            "address_2": "SUITE 1051",
            "city": "FORT HOOD",
            "state": "TX",
            "postal_code": "76544",
            "telephone_number": "254-286-7402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTOSON",
        "first_name": "BEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-19",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.025584",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "OH",
            "license": "30.025584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Andrew Ortiz, P.A.,C.
• Michael Kale Ortiz, DDS
• Edward Kuffour Osei, PHARMACIST
• Philip Bernard Ossowski, PA
• Brandon Matthew Oswald, MD
• Isaac Deryl Overholtzer
• Michele Renee Overholtzer, LVN
• Kimberly A. Overly, BCBA
• Heather Marie Owens, CRNA
• Grace Owinje, MD

• Periodontics in Fort Hood, TX
• Providers in Fort Hood, TX by specialty
• Periodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; 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.