Chase Bennett Professional Dental Corporation

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

CHASE BENNETT PROFESSIONAL DENTAL CORPORATION

Practice address

5230 Carroll Canyon Rd Ste 326
San Diego, CA 92121-1781

Phone

(619) 494-5091

NPI assigned

Feb 23, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Chase Bennett, DDSNPI 1043566706

Title

Ceo

Phone

(918) 638-3102

Specialties & licenses 1

Addresses

Other names 1

• CranioSpa Bennett Dental Group Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chase Alan Bennett, DDS

  • Specialist
  • San Diego, CA
  • NPI 1043566706

  Dentist

  NPD Authorized official

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

{
    "created_epoch": "1708646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708646400000",
    "number": "1972369288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5230 CARROLL CANYON RD STE 326",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5230 CARROLL CANYON RD STE 326",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211781",
            "telephone_number": "619-494-5091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHASE BENNETT PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-23",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "CHASE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "918-638-3102",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CranioSpa Bennett Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Don Charoen, DO
• Kalyalak Charoenraksa
• Kavalin Charoenraksa
• Juliann Chartier
• Kara Mary Chartier, L.AC.
• Ava Lou Carmichael Chase, ARNP
• Diana Stroud Chase, CFNP
• Donna Katherine Chase, R.N., P.H.N.
• Elizabeth Chase, M.A.
• Kristina Haley Chase

• Dentist in San Diego, CA
• Providers in San Diego, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.