Arnold Emery Benak Jr., DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6190 Issued in CT

Practice address

317 Flanders Rd
Suites 204-205
East Lyme, CT 06333-1711

Phone

(860) 739-5700

Fax

(860) 739-5279

NPI assigned

Aug 4, 2006

Last updated

Oct 19, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Arnold E. Benak Jr. DMD LLC

  • General Practice Dentistry
  • Waterford, CT
  • NPI 1841369741
  NPD (past) Authorized official
• Resolute BPW, LLC

  dba Raccio & Drew Dental Group, LLC

  • General Practice Dentistry
  • Waterford, CT
  • NPI 1801446869
  NPD (past)

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1699783753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PEPPERBOX RD",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063853511",
            "telephone_number": "860-287-4400",
            "fax_number": "860-287-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 FLANDERS RD",
            "address_2": "SUITES 204-205",
            "city": "EAST LYME",
            "state": "CT",
            "postal_code": "063331711",
            "telephone_number": "860-739-5700",
            "fax_number": "860-739-5279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENAK",
        "first_name": "ARNOLD",
        "middle_name": "EMERY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "6619",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "6190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT",
            "identifier": "1699783753",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699783753",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chris Apicelli, OD
• James J. Archambeault, LADC
• Felicia Vieira Baker
• Baytide Health
• William L Beason, MD
• Caitlin Blackburn, LMSW
• Amy Blodgett, MD
• Renee Ann Brown, D.C.
• B Geoffrey Burnham, PA-C
• Thomas J. Butcher, M.A., LPC

• General Practice Dentistry in East Lyme, CT
• Providers in East Lyme, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.