Individual provider Active NPI

Joseph Zvi Benderson, D.M.D.

  • General Practice Dentistry
  • Odenton, MD
National Provider Identifier
1578770780
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13157 Issued in MD
Practice address
1940 Hackberry CT
Odenton, MD 21113-2926
Phone
(301) 442-7188
NPI assigned
May 17, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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 13157 MD Primary

Addresses

Primary practice location

1940 Hackberry CT
Odenton, MD 21113-2926

Mailing address

1940 Hackberry CT
Odenton, MD 21113-2926
Phone (301) 442-7188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20150629001459 MD Order and Referring Only - DentistPractitioner - Dentist 0345552717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13157MDMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578770780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 HACKBERRY CT",
            "city": "ODENTON",
            "state": "MD",
            "postal_code": "211132926",
            "telephone_number": "301-442-7188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 HACKBERRY CT",
            "city": "ODENTON",
            "state": "MD",
            "postal_code": "211132926",
            "telephone_number": "301-442-7188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENDERSON",
        "first_name": "JOSEPH",
        "middle_name": "ZVI",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "13157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odenton, MD

Sources for this page

Verify at the official NPI Registry.