Fred Benzenhafer DMD PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

FRED BENZENHAFER DMD PA

Practice address

100 NE 23Rd St. Ste 101
Pompano Beach, FL 33060

Phone

(877) 649-3485

NPI assigned

Oct 26, 2021

Organization subpart

No

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

Authorized official

Name

Fred Benzenhafer

Title

Owner

Phone

(315) 454-6000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686614400000",
    "number": "1730843897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132203189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NE 23RD ST. STE 101",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "33060",
            "telephone_number": "877-649-3485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED BENZENHAFER DMD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-26",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A",
        "authorized_official_last_name": "BENZENHAFER",
        "authorized_official_first_name": "FRED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-454-6000"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.