Neal R Benham, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

5000850015 Issued in WI

Practice address

3131 Stein Blvd
Eau Claire, WI 54701-6997

Phone

(715) 835-7172

Fax

(715) 835-5841

NPI assigned

Mar 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780701821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 STEIN BLVD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016997",
            "telephone_number": "715-835-7172",
            "fax_number": "715-835-5841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 STEIN BLVD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016997",
            "telephone_number": "715-835-7172",
            "fax_number": "715-835-5841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENHAM",
        "first_name": "NEAL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WI",
            "license": "5000850015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI MA",
            "identifier": "38373400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beller Medical Transportation LLC
• Ashtyn Bellinger
• Anna Grundstrom Bender, M.D.
• Jeffrey Michael Bender, MD
• Kelly Bender
• Alison Hart Bennett, CNM
• Rebecca Jane Bennett, PHARMD
• David W Benning, PAC
• Jeffre J Benson, MD
• Laura C Bentley, M.D.

• Pediatric Dentistry in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Pediatric Dentistry in Wisconsin

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.