Individual provider Active NPI

Benjamin Daniel Owen, DMD

  • General Practice Dentistry
  • Jbsa Fort Sam Houston, TX
National Provider Identifier
1629036371
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
56467 Issued in CA
Practice address
3599 Winfield Scott Rd
Suite 3401
Jbsa Fort Sam Houston, TX 78234
Phone
(210) 221-8982
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D6571 AZ
General Practice Dentistry 1223G0001X 56467 CA Primary

Addresses

Primary practice location

3599 Winfield Scott Rd
Suite 3401
Jbsa Fort Sam Houston, TX 78234

Mailing address

3599 Winfield Scott Rd
Suite 3401
Jbsa Fort Sam Houston, TX 78234
Phone (210) 221-8982

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

LicenseStateTypeSpecialty
D6571AZMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1629036371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3599 WINFIELD SCOTT RD",
            "address_2": "SUITE 3401",
            "city": "JBSA FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "78234",
            "telephone_number": "210-221-8982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3599 WINFIELD SCOTT RD",
            "address_2": "SUITE 3401",
            "city": "JBSA FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "78234",
            "telephone_number": "210-221-8982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "BENJAMIN",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D6571",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "56467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbsa Fort Sam Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.