Neal R. Benham D.D.S.,S.C.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

NEAL R. BENHAM D.D.S.,S.C.

Practice address

3131 Stein Blvd
Eau Claire, WI 54701-6997

Phone

(715) 835-7172

Fax

(715) 835-5841

NPI assigned

Oct 5, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Shelley M Engedal

Title

Office MGR.

Phone

(715) 835-7172

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286236800000",
    "number": "1720397987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 STEIN BLVD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016997",
            "telephone_number": "715-835-7172",
            "fax_number": "715-835-5841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 STEIN BLVD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016997",
            "telephone_number": "715-835-7172",
            "fax_number": "715-835-5841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEAL R. BENHAM D.D.S.,S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-05",
        "last_updated": "2010-10-05",
        "status": "A",
        "authorized_official_last_name": "ENGEDAL",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MGR.",
        "authorized_official_telephone_number": "715-835-7172",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Pediatric Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2010; 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.