Benson Oral Surgery and Dental Implants, LLC

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

License

12011706A Issued in IN

Legal business name

BENSON ORAL SURGERY AND DENTAL IMPLANTS, LLC

Practice address

8809 W 400 N
Suite 2
Michigan City, IN 46360-9330

Phone

(219) 879-8710

NPI assigned

Apr 24, 2012

Organization subpart

No

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

Authorized official

Name

Gregory Steven Benson, DDSNPI 1982704847

Title

Owner

Phone

(219) 879-8710

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gregory S Benson, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Michigan City, IN
  • NPI 1982704847
  NPD (past) Authorized official

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

{
    "created_epoch": "1335225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335225600000",
    "number": "1740548015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8809 W 400 N",
            "address_2": "SUITE 2",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463609330",
            "telephone_number": "219-879-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8809 W 400 N",
            "address_2": "SUITE 2",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463609330",
            "telephone_number": "219-879-8710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENSON ORAL SURGERY AND DENTAL IMPLANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-24",
        "last_updated": "2012-04-24",
        "status": "A",
        "authorized_official_last_name": "BENSON",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "219-879-8710",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "12011706A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33791200",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201031920A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Antoinette Becerra
• Joyce Elaine Beckner
• Razia Begum, MD
• Charesa Bellen
• Vamshi Kiran Bende, M.D
• Gregory S Benson, DDS
• Rachel Heard Benson, PT
• Amie Bernard, LMHC
• Christy Berrier, R.D., C.D.
• Michael J Best, MD

• Oral and Maxillofacial Surgery Clinic/Center in Michigan City, IN
• Providers in Michigan City, IN by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; 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.