Individual provider Active NPI

Benjamin Tobias Pliska, DDS, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Minneapolis, MN
National Provider Identifier
1881886919
Registry record updated Aug 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
D12471 Issued in MN
Practice address
1314 Marquette Ave Apt 1303
Minneapolis, MN 55403-4112
Phone
(612) 986-5539
NPI assigned
Aug 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X D12471 MN Primary

Addresses

Primary practice location

1314 Marquette Ave Apt 1303
Minneapolis, MN 55403-4112

Mailing address

1314 Marquette Ave Apt 1303
Minneapolis, MN 55403-4112
Phone (612) 986-5539

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
D12471MNMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186963200000",
    "number": "1881886919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 MARQUETTE AVE APT 1303",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554034112",
            "telephone_number": "612-986-5539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 MARQUETTE AVE APT 1303",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554034112",
            "telephone_number": "612-986-5539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLISKA",
        "first_name": "BENJAMIN",
        "middle_name": "TOBIAS",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-13",
        "last_updated": "2007-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MN",
            "license": "D12471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2007; 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.