Benjamin W Lacy Sr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN4347 Issued in FL

Practice address

30 Office Park Dr
Palm Coast, FL 32137-3808

Phone

(386) 446-3883

Fax

(386) 445-9318

NPI assigned

Mar 16, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Flagler Dental Associates PA

  • General Practice Dentistry
  • Palm Coast, FL
  • NPI 1376798280
  NPD (past)

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942334396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 OFFICE PARK DR",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321373808",
            "telephone_number": "386-446-3883",
            "fax_number": "386-445-9318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 OFFICE PARK DR",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321373808",
            "telephone_number": "386-446-3883",
            "fax_number": "386-445-9318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACY",
        "first_name": "BENJAMIN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN4347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Kutay, LMT
• Viktoriya La Rosa
• Ann Marie La Touche
• Kirstin Labell, MD
• Marilene Gopez Lacson, ARNP
• Beatrice Lafleur, LCSW
• John Laforte, LCSW
• Carol Ann Lagana, PTA
• Elizabeth Anne Lagasse, MHS, RD, LDN
• Teresa Lago

• General Practice Dentistry in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• General Practice Dentistry in Florida

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.