Individual provider Active NPI

Benjamin Alan Sandler, D.D.S.

  • General Practice Dentistry
  • Ellicott City, MD
National Provider Identifier
1700976602
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7859 Issued in MD
Practice address
8492 Baltimore National Pike
Ellicott City, MD 21043-3370
Phone
(410) 750-9330
Fax
(301) 725-2147
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7859 MD Primary

Addresses

Primary practice location

8492 Baltimore National Pike
Ellicott City, MD 21043-3370

Mailing address

9704 Polished Stone
Columbia, MD 21046-2801
Phone (410) 792-8377

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20160105000000 MD Order and Referring Only - DentistPractitioner - Dentist 1759683097

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700976602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9704 POLISHED STONE",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210462801",
            "telephone_number": "410-792-8377",
            "fax_number": "301-725-2147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8492 BALTIMORE NATIONAL PIKE",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210433370",
            "telephone_number": "410-750-9330",
            "fax_number": "301-725-2147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDLER",
        "first_name": "BENJAMIN",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "7859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

Verify at the official NPI Registry.