Active NPI
Benjamin Phan, DDS
- Dentist
- Martinsville, IN
National Provider Identifier
1609766591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12014785A
- Practice address
- 9351 In-144
Martinsville, IN 46151 - Phone
- (765) 302-2128
- NPI assigned
- Jul 3, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12014785A | IN | |
| Dentist | 122300000X | 12014785A | IN | Primary |
Addresses
Primary practice location
9351 In-144
Martinsville, IN 46151
Mailing address
351 Central State Blvd
Indianapolis, IN 46222-0105
Phone (713) 480-2184
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12014785A | IN | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1751500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751500800000",
"number": "1609766591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "351 CENTRAL STATE BLVD",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462220105",
"telephone_number": "713-480-2184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9351 IN-144",
"city": "MARTINSVILLE",
"state": "IN",
"postal_code": "46151",
"telephone_number": "765-302-2128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "BENJAMIN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-07-03",
"last_updated": "2025-07-03",
"certification_date": "2025-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IN",
"license": "12014785A",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IN",
"license": "12014785A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Martinsville, IN
- Arlene M. Parker, PMHNP-BC
- Renee Parker, CADAC II, MATS
- Emily Pasch
- Rolan A Pascual, MD
- Kenisha Renee Peden, LCSW
- Emma Phelps
- Michael Anthony Phelps, D.C.
- Philip H. Nowak, O.D., P.C.
- Pinnacle Treatment Centers in-I, LLC (Recovery Works Morgan)
- Pinnacle Treatment Centers in-I, LLC (Recovery Works Martinsville)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.