NPIMap

Organization Active NPI

Benton Family Dental PC

  • Dental Clinic/Center
  • Grand Rapids, MI
National Provider Identifier
1699154153
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
014521 Issued in MI
Legal business name
BENTON FAMILY DENTAL PC
Practice address
3299 Clear Vista CT NE, Ste a
Grand Rapids, MI 49525
Phone
(616) 361-0654
Fax
(616) 361-9823
NPI assigned
May 29, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Authorized official

Name
Dr. Stephanie M Benton-Langejans, DDSNPI 1710144183
Title
President
Phone
(616) 361-0654

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 014521 MI Primary

Addresses

Primary practice location

3299 Clear Vista CT NE, Ste a
Grand Rapids, MI 49525

Mailing address

3299 Clear Vista CT NE, Ste a
Grand Rapids, MI 49525
Phone (616) 361-0654

National Provider Directory

National Provider Directory

Locations

3299 Clear Vista Ct NE
Ste A
Grand Rapids, MI 49525
Phone (616) 361-0654

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1432857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709164800000",
    "number": "1699154153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3299 CLEAR VISTA CT NE, STE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49525",
            "telephone_number": "616-361-0654",
            "fax_number": "616-361-9823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3299 CLEAR VISTA CT NE, STE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49525",
            "telephone_number": "616-361-0654",
            "fax_number": "616-361-9823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENTON FAMILY DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-29",
        "last_updated": "2024-02-29",
        "certification_date": "2022-09-29",
        "status": "A",
        "authorized_official_last_name": "BENTON-LANGEJANS",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-361-0654",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MI",
            "license": "014521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; 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.