Matthew Bagley Benson, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN013535 Issued in GA

Practice address

2489 Diplomat Pkwy E
Cape Coral, FL 33909-5422

Phone

(239) 652-1800

NPI assigned

Jun 28, 2007

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

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1528265196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2489 DIPLOMAT PKWY E",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339095422",
            "telephone_number": "239-652-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2489 DIPLOMAT PKWY E",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339095422",
            "telephone_number": "239-652-1800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2292 Dalton Dr Ste F",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "TN",
            "postal_code": "370438961",
            "country_code": "US",
            "telephone_number": "931-503-1111",
            "fax_number": "931-553-0876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENSON",
        "first_name": "MATTHEW",
        "middle_name": "BAGLEY",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-28",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melany Benitez Palomino
• Chabeli Benitez
• Elizabeth Benitez
• Patricia Bennett, SLP
• Nicole Benninghoff, COTA/L
• Donalie M. Benyak, LMHC, NCC
• Philip Anthony Benyola Sr., LMT
• Lanie Soriano Benzon, RPT
• Hany Beovides Rodriguez
• Emilia Berardelli

• General Practice Dentistry in Cape Coral, FL
• Providers in Cape Coral, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; 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.

Verify at the official NPI Registry.