NPIMap

Organization Active NPI

Desert Dental

Doing business as Ilya Benjamin

  • General Practice Dentistry
  • Henderson, NV
National Provider Identifier
1487884268
Registry record updated Jul 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5852 Issued in NV
Legal business name
DESERT DENTAL
Doing business as
Ilya Benjamin
Practice address
55 S Valle Verde Dr
Suite #250
Henderson, NV 89012-3433
Phone
(702) 260-1890
Fax
(702) 260-7936
NPI assigned
Jul 15, 2009
Last updated
Jul 10, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
DESERT DENTALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 10, 2013

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

Authorized official

Name
Dr. Ilya Benjamin, DMDNPI 1326027095
Title
Owner/Doctor
Phone
(702) 260-1890

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5852 NV Primary

Addresses

Primary practice location

55 S Valle Verde Dr
Suite #250
Henderson, NV 89012-3433

Mailing address

55 S. Valle Verde Dr.
Suite #250
Henderson, NV 89012
Phone (702) 260-1890

Other identifiers 1

IdentifierTypeStateIssuer
1326027095MedicaidNV

Other names 1

  • Ilya Benjamin Doing business as

National Provider Directory

National Provider Directory
Part of
Desert Dental

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1247616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373414400000",
    "number": "1487884268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 S. VALLE VERDE DR.",
            "address_2": "SUITE #250",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "89012",
            "telephone_number": "702-260-1890",
            "fax_number": "702-260-7936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 S VALLE VERDE DR",
            "address_2": "SUITE #250",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890123433",
            "telephone_number": "702-260-1890",
            "fax_number": "702-260-7936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT DENTAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DESERT DENTAL",
        "enumeration_date": "2009-07-15",
        "last_updated": "2013-07-10",
        "status": "A",
        "authorized_official_last_name": "BENJAMIN",
        "authorized_official_first_name": "ILYA",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "702-260-1890",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "5852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326027095",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ilya Benjamin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.