Individual provider Active NPI

Ben F Carter, D.D.S

  • Dentist
  • Jacksonville, FL
National Provider Identifier
1851679666
Registry record updated Jan 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
19373 Issued in FL
Practice address
5937 University Blvd W
Jacksonville, FL 32216-4911
Phone
(904) 730-4150
Fax
(904) 730-4193
NPI assigned
Jul 27, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 19373 FL Primary

Addresses

Primary practice location

5937 University Blvd W
Jacksonville, FL 32216-4911

Mailing address

11718 Fitchwood Cir
Jacksonville, FL 32258-4503

Other identifiers 1

IdentifierTypeStateIssuer
003936600MedicaidFL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150603002211 FL Order and Referring Only - DentistPractitioner - Dentist 9830410703

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19373FLMDDentist

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1311724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357689600000",
    "number": "1851679666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11718 FITCHWOOD CIR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322584503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5937 UNIVERSITY BLVD W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164911",
            "telephone_number": "904-730-4150",
            "fax_number": "904-730-4193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "BEN",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-27",
        "last_updated": "2013-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "19373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003936600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.