Organization Active NPI

Robert J. Benke, D.D.S., P.C.

  • Dental Clinic/Center
  • Greeley, CO
National Provider Identifier
1629297726
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
ROBERT J. BENKE, D.D.S., P.C.
Practice address
3705 W 12TH St Ste 3C
Greeley, CO 80634-2550
Phone
(970) 356-2120
Fax
(970) 356-1013
NPI assigned
Apr 25, 2007
Last updated
Mar 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Dr. Robert John Benke, DDSNPI 1477556314
Title
Dentist
Phone
(970) 356-2120

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

3705 W 12TH St Ste 3C
Greeley, CO 80634-2550

Mailing address

3705 W 12TH St Ste 3C
Greeley, CO 80634-2550
Phone (970) 356-2120

Other practice location 1

1640 25th Ave
Suite B
Greeley, CO 80634-4959
Phone (970) 356-2120

Other identifiers 2

IdentifierTypeStateIssuer
02052538MedicaidCO
19753543MedicaidCO

National Provider Directory

National Provider Directory

Locations

1640 25th Ave
Ste B
Greeley, CO 80634
Phone (970) 356-2120

3705 W 12th St
Ste 3C
Greeley, CO 80634
Phone (970) 356-2120

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1629297726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 W 12TH ST STE 3C",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806342550",
            "telephone_number": "970-356-2120",
            "fax_number": "970-356-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 W 12TH ST STE 3C",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806342550",
            "telephone_number": "970-356-2120",
            "fax_number": "970-356-1013"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1640 25th Ave",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Greeley",
            "state": "CO",
            "postal_code": "806344959",
            "country_code": "US",
            "telephone_number": "970-356-2120",
            "fax_number": "970-356-1013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ROBERT J. BENKE, D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "BENKE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "970-356-2120",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02052538",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19753543",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.