Active NPI
Benjamin J Driver, DMD
- General Practice Dentistry
- Roseburg, OR
National Provider Identifier
1518251065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D9318
- Practice address
- 1651 NW Hughwood CT
Roseburg, OR 97471-8834 - Phone
- (541) 672-8187
- Fax
- (541) 672-0224
- NPI assigned
- Jun 1, 2011
- Last updated
- Jun 1, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D9318 | OR | Primary |
Addresses
Primary practice location
1651 NW Hughwood CT
Roseburg, OR 97471-8834
Mailing address
299 Hidden Valley LN
Roseburg, OR 97471-8255
Phone (503) 956-1066
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160415001869 | OR | Order and Referring Only - Dentist | 6608174164 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D9318 | OR | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mark R Driver DMD PC | General Practice | Past | Accepting new patients |
| Driver & Driver PC, Dba Driver Dentistry | General Practice | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Driver Dentistry
- General Practice Dentistry
- Roseburg, OR
- NPI 1881203784
-
- General Practice Dentistry
- Roseburg, OR
- NPI 1447538392
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306886400000",
"number": "1518251065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "299 HIDDEN VALLEY LN",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974718255",
"telephone_number": "503-956-1066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1651 NW HUGHWOOD CT",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974718834",
"telephone_number": "541-672-8187",
"fax_number": "541-672-0224"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRIVER",
"first_name": "BENJAMIN",
"middle_name": "J",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-01",
"last_updated": "2011-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OR",
"license": "D9318",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Roseburg, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; 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.