Brandon Keith Bennett, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2009013178 Issued in MO

Practice address

202 N Maple St
Eldon, MO 65026-1776

Phone

(573) 392-5213

Fax

(573) 392-5213

NPI assigned

Mar 9, 2009

Last updated

Sep 5, 2013By the provider in NPPES

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 MO

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Brandon K Bennett DDS LLC

  dba Eldon Family Dentistry

  • Dental Clinic/Center
  • Eldon, MO
  • NPI 1801416722
  NPD Authorized official

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

{
    "created_epoch": "1236556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378339200000",
    "number": "1609017490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 MOCKINGBIRD RD",
            "city": "LAKE OZARK",
            "state": "MO",
            "postal_code": "650497108",
            "telephone_number": "314-704-0881",
            "fax_number": "573-392-5213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 N MAPLE ST",
            "city": "ELDON",
            "state": "MO",
            "postal_code": "650261776",
            "telephone_number": "573-392-5213",
            "fax_number": "573-392-5213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "BRANDON",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-09",
        "last_updated": "2013-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2009013178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Allison, FNP
• Richard Mark Anderegg, PLPC, MS
• Apothecare Health Services
• Evgeniya Banina, M.D.
• BC King DDS PC (King Dental Clinic)
• Paul Bernabe, M.D.
• Jeanell Bertels, PHARM D
• Kayla Jean Blaes, FNP
• Henry Keiler Bluhm Jr., PA-C
• Megan Boehmer, PHARM-D

• General Practice Dentistry in Eldon, MO
• Providers in Eldon, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2013; 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.