Individual provider Active NPI

Jennifer Elizabeth Benich, RDN, LD

  • Registered Dietitian
  • Flower Mound, TX
National Provider Identifier
1710538699
Registry record updated Feb 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT86171 Issued in TX
Practice address
833 Canongate Dr
Flower Mound, TX 75022-8012
Phone
(469) 288-3407
NPI assigned
Sep 23, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DT86171 TX Primary

Addresses

Primary practice location

833 Canongate Dr
Flower Mound, TX 75022-8012

Mailing address

833 Canongate Dr
Flower Mound, TX 75022-8012
Phone (469) 288-3407

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DT86171TXMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675555200000",
    "number": "1710538699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 CANONGATE DR",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750228012",
            "telephone_number": "469-288-3407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 CANONGATE DR",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750228012",
            "telephone_number": "469-288-3407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENICH",
        "first_name": "JENNIFER",
        "middle_name": "ELIZABETH",
        "credential": "RDN, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-23",
        "last_updated": "2023-02-05",
        "certification_date": "2023-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT86171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flower Mound, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2023; 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.