Christian Clarence Bennerman, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

8190 Issued in TN

Practice address

2653 Lakevilla Dr
Nashville, TN 37217-3836

Phone

(615) 840-8149

Fax

(615) 982-8989

NPI assigned

Nov 22, 2006

Last updated

Dec 13, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA, TN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576195200000",
    "number": "1598830770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13181 OLD NASHVILLE HWY",
            "address_2": "SUITE 110",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371674032",
            "telephone_number": "615-459-9296",
            "fax_number": "615-459-9686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2653 LAKEVILLA DR",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372173836",
            "telephone_number": "615-840-8149",
            "fax_number": "615-982-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNERMAN",
        "first_name": "CHRISTIAN",
        "middle_name": "CLARENCE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "8190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q052725",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nontawan Benja-Athonsirikul
• Benjamin Holmes Counseling, PLLC
• Jennifer Benjamin, D.O.
• Ramsey Benkert, PT
• Alexander Bennatan
• Monique Michelle Bennerman, M.D.
• Kayla Bennett-Shaffer
• Adrian Vantrice Bennett, LPC
• Amanda Lauren Bennett, MD
• Ashley Anne Bennett, PHARM D

• Oral and Maxillofacial Surgery (Dentist) in Nashville, TN
• Providers in Nashville, TN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.