Individual provider Active NPI

John Benecchi, D.M.D.

  • General Practice Dentistry
  • Revere, MA
National Provider Identifier
1568577864
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13275 Issued in MA
Practice address
140 School St
Revere, MA 02151-3013
Phone
(781) 289-0839
Fax
(781) 286-1949
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 13275 MA Primary

Addresses

Primary practice location

140 School St
Revere, MA 02151-3013

Mailing address

140 School St
Revere, MA 02151-3013
Phone (781) 189-0839

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150713001853 MA Order and Referring Only - DentistPractitioner - Dentist 1557674058

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13275MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
John L. Benecchi, DMD General Practice Past Accepting new patients
Benecchi Dental Group, PLLC 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568577864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 SCHOOL ST",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021513013",
            "telephone_number": "781-189-0839",
            "fax_number": "781-286-1949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 SCHOOL ST",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021513013",
            "telephone_number": "781-289-0839",
            "fax_number": "781-286-1949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENECCHI",
        "first_name": "JOHN",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "13275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Revere, MA

Sources for this page

Verify at the official NPI Registry.