Tracy C. Benton Jr., DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3057 Issued in LA

Practice address

1310 S Range Ave
Denham Springs, LA 70726-4810

Phone

(225) 664-0040

Fax

(225) 664-0042

NPI assigned

Mar 3, 2014

Last updated

Mar 3, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dr Tracy C Benton DDS Apdc

  • General Practice Dentistry
  • Denham Springs, LA
  • NPI 1366581886
  NPD (past) Authorized official

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

{
    "created_epoch": "1393804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393804800000",
    "number": "1487079208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 952",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707270952",
            "telephone_number": "225-664-0040",
            "fax_number": "225-664-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 S RANGE AVE",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707264810",
            "telephone_number": "225-664-0040",
            "fax_number": "225-664-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTON",
        "first_name": "TRACY",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-03",
        "last_updated": "2014-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "3057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1830577",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bellcare Transport LLC
• Bencaz Family Dentistry LLC (Jimmie Hammack Family Dentistry)
• Jarrad G Bencaz, DDS
• Brittney Bennett, PHARMD
• Crystal Bonura Bennett, M.S.
• Victoria Susan Benton, LPC
• Beringer and Richardson Dental Partnership (Advanced Dental Care)
• Frederick Porter Beringer, DDS
• Megan Bernard, LOTR
• Bernards Family Pharmacy LLC

• General Practice Dentistry in Denham Springs, LA
• Providers in Denham Springs, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; 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.