Individual provider Active NPI

Miller Benjamin Lewis, DDS

  • Dentist
  • Alexandria, VA
National Provider Identifier
1740409085
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401005355 Issued in VA
Practice address
801 N Pitt St
111
Alexandria, VA 22314-1765
Phone
(703) 549-1288
Fax
(703) 549-1242
NPI assigned
Apr 25, 2007
Sex
Male
Sole proprietor
Yes

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
Dentist 122300000X 0401005355 VA Primary

Addresses

Primary practice location

801 N Pitt St
111
Alexandria, VA 22314-1765

Mailing address

801 N Pitt St
111
Alexandria, VA 22314-1765
Phone (703) 549-1288

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0401005355VAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740409085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 N PITT ST",
            "address_2": "111",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223141765",
            "telephone_number": "703-549-1288",
            "fax_number": "703-549-1242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N PITT ST",
            "address_2": "111",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223141765",
            "telephone_number": "703-549-1288",
            "fax_number": "703-549-1242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "MILLER",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401005355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.