Benton Dwight, CLINICAL PHARMACIST

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

5490 Issued in NM

Practice address

2050A 2ND St SE
Kirtland AFB, NM 87117-7274

Phone

(505) 846-3200

NPI assigned

Jun 11, 2008

Last updated

Dec 5, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1952561250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050A 2ND ST SE",
            "city": "KIRTLAND AFB",
            "state": "NM",
            "postal_code": "871175901",
            "telephone_number": "505-846-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050A 2ND ST SE",
            "city": "KIRTLAND AFB",
            "state": "NM",
            "postal_code": "871177274",
            "telephone_number": "505-846-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DWIGHT",
        "first_name": "BENTON",
        "credential": "CLINICAL PHARMACIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-11",
        "last_updated": "2023-12-05",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NM",
            "license": "5490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Raymond Craddock, DDS
• Rachel Jane Darnell-Miller, LCSW
• Kirsten Elizabeth Delambo, PHD
• Alan K Dunaway, D.C.
• Tina Dunlap, FNP-C
• Kenneth Egerstrom, MD
• Antonio J. Eppolito, MD
• Anna Vladimirovna Fedotova
• Steven C. Fenzl, DDS
• Britney L Fiandra, RD

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Kirtland AFB, NM
• Providers in Kirtland AFB, NM by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; 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.