Jerry Dell Bennett Jr., DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11534 Issued in GA

Practice address

305 University Dr
Suite 3
Valdosta, GA 31602-2626

Phone

(229) 671-1900

Fax

(229) 671-1999

NPI assigned

Dec 19, 2006

Last updated

Sep 11, 2025By 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 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1679636419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 UNIVERSITY DR",
            "address_2": "SUITE 3",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022626",
            "telephone_number": "229-671-1900",
            "fax_number": "229-671-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 UNIVERSITY DR",
            "address_2": "SUITE 3",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022626",
            "telephone_number": "229-671-1900",
            "fax_number": "229-671-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "JERRY",
        "middle_name": "DELL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "11534",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "11534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS",
            "identifier": "100967",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL",
            "identifier": "9813258",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1427670",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deann Benefield, LMSW
• Benevolent Hearts, LLC
• Rachel Bennefield
• Bennett & Maxwell Family Dentistry
• Bennett P Hogan MD PC
• Paula L Bennett, RNC
• Robert Daniel Bennett, MD
• Robert Hal Bennett Jr., MPT
• Katheryn Bergemann, RBT
• Latonya Berry

• General Practice Dentistry in Valdosta, GA
• Providers in Valdosta, 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 Sep 11, 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.

Verify at the official NPI Registry.