Individual provider Active NPI

John J Benusis, DMD

  • Dentist
  • Danbury, CT
National Provider Identifier
1871783084
Registry record updated Jul 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3953 Issued in CT
Practice address
68 West St
Danbury, CT 06810
Phone
(203) 744-1712
Fax
(203) 744-1712
NPI assigned
Jul 25, 2007
Last updated
Jul 25, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 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 3953 CT Primary

Addresses

Primary practice location

68 West St
Danbury, CT 06810

Mailing address

68 West St
Danbury, CT 06810
Phone (203) 744-1712

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20190321000966 CT Order and Referring Only - DentistPractitioner - Dentist 4587904958

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3953CTMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185321600000",
    "number": "1871783084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 WEST ST",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "06810",
            "telephone_number": "203-744-1712",
            "fax_number": "203-744-1712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 WEST ST",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "06810",
            "telephone_number": "203-744-1712",
            "fax_number": "203-744-1712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENUSIS",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-25",
        "last_updated": "2007-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "3953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.