Wakeshi Lanise Benson, DDS
Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Chester, VA
NPI 1760675227 · NPPES record last updated May 8, 2014
Key facts
- NPI
- 1760675227
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
- License
- 0401411415 (VA)
- Practice address
- 12230 Iron Bridge Rd
Suite B
Chester, VA 23831-1534 - Phone
- (804) 454-1888
- Fax
- (804) 454-1868
- NPI assigned
- Aug 19, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901017909 | MI | MD | Dentist |
| 0401411415 | VA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901017909 | MI | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 0401411415 | VA | Yes |
Addresses
Primary practice location
12230 Iron Bridge Rd
Suite B
Chester, VA 23831-1534
Mailing address
12230 Iron Bridge Rd
Suite B
Chester, VA 23831-1534
Phone (804) 454-1888
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All providers in Chester, VA · Orthodontics and Dentofacial Orthopedics Dentistry in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 8, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.