Joseph Dibenedetto DMD PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

JOSEPH DIBENEDETTO DMD PLLC

Doing business as

Son Shine Pediatric Dentistry

Practice address

9271 Peach St
Waterford, PA 16441-4025

Phone

(607) 725-5708

NPI assigned

Jun 4, 2024

Last updated

Jun 4, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Joseph Dibenedetto, DMDNPI 1790287506

Title

Pediatric Dentist

Phone

(607) 725-5708

Specialties & licenses 1

Addresses

Other names 1

• Son Shine Pediatric Dentistry Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joseph Shine Dibenedetto, DMD

  • Pediatric Dentistry
  • Princess Anne, MD
  • NPI 1790287506
  NPD Authorized official

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1912748989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9271 PEACH ST",
            "city": "WATERFORD",
            "state": "PA",
            "postal_code": "164414025",
            "telephone_number": "607-725-5708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9271 PEACH ST",
            "city": "WATERFORD",
            "state": "PA",
            "postal_code": "164414025",
            "telephone_number": "607-725-5708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH DIBENEDETTO DMD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "DIBENEDETTO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "607-725-5708",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Son Shine Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ashley Huegel
• Anne Marie Hull, MA, NCC, LPC
• John R Slagle
• Kirsten Johnson
• Rebecca Jordan
• Lisa R. Keiser, O.D.
• Paige M King, PA-C
• Brandon M Kudasik, PT, DPT
• Kuzma Physical Therapy and Sports Medicine LLC
• Brian Edward Lentz, D.M.D.

• Dental Clinic/Center in Waterford, PA
• Providers in Waterford, PA by specialty
• Dental Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.