Beau C. Benich, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13103 Issued in GA

Practice address

2220 Blackwell Chase CT
Marietta, GA 30062-8505

Phone

(770) 971-4662

Fax

(770) 644-0045

NPI assigned

Nov 1, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629155387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 BLACKWELL CHASE PARK",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30062",
            "telephone_number": "770-971-4662",
            "fax_number": "770-644-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 BLACKWELL CHASE CT",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300628505",
            "telephone_number": "770-971-4662",
            "fax_number": "770-644-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENICH",
        "first_name": "BEAU",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "13103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natoya Nicola Bender, NP-C
• Alan L Benedict, M.D.
• William John Benedict Jr., M.D.
• Benevis, LLC
• Angelina Benfield
• Timothy A. Benich, DDS
• Katiana J Benn
• Carrie Heather Bennett, CRNP
• Courtney Alleen Bennett, FNP
• Joanna Claire Bennett, OTR/L

• General Practice Dentistry in Marietta, GA
• Providers in Marietta, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.