Active NPI
Benjamin Anowia
- Dentist
- Glendale, CA
National Provider Identifier
1720863863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 109193
- Practice address
- 3900 San Fernando Rd Ste 1017a
Glendale, CA 91204-2899 - Phone
- (818) 528-4844
- NPI assigned
- Aug 28, 2023
- Last updated
- Aug 28, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 109193 | CA | Primary |
Addresses
Primary practice location
3900 San Fernando Rd Ste 1017a
Glendale, CA 91204-2899
Mailing address
2242 Alarose Way
Riverbank, CA 95367-9531
Phone (209) 988-7986
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240126004022 | CA | Order and Referring Only - Dentist | 3375996200 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 109193 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jennifer Herbert Dental Corporation | Dentist | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- Glendale, CA
- NPI 1295230738
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693180800000",
"number": "1720863863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2242 ALAROSE WAY",
"city": "RIVERBANK",
"state": "CA",
"postal_code": "953679531",
"telephone_number": "209-988-7986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3900 SAN FERNANDO RD STE 1017A",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912042899",
"telephone_number": "818-528-4844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANOWIA",
"first_name": "BENJAMIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-08-28",
"last_updated": "2023-08-28",
"certification_date": "2023-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "109193",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.