DR. GARY LYNN BENNICOFF, D.D.S. - NPI NUMBER 1487782454

Summary

Provider Name: DR. GARY LYNN BENNICOFF, D.D.S.

NPI Number: 1487782454

Clasification: Dentist (1223G0001X)

Specialization: General Practice

Address:
1305 TATAMY RD
EASTON, PA
ZIP 18045

Phone Number: (610) 252-2223



Detailed Information

DR. Gary Lynn Bennicoff, D.D.S. is a general practice dentist in Easton, PA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. The assigned NPI number for this provider is 1487782454 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business address is:

1305 TATAMY RD
EASTON, PA
ZIP 18045-474
Phone: (610) 252-2223
Fax: (610) 252-4099

The enumeration date for this NPI number is 3/1/2007 and was last updated on 9/2/2008.

Map - Location of Practice

Similar Providers

NPI Provider Name / Taxonomy
1053723502 FADI KARAM DDS PLLC
Dentist
1083927305 ALAN V DILSAVER DDS LTD
Dentist
1134118672 DR. JOSEPH JUDE ARNONE, DMD
Dentist (Oral and Maxillofacial Pathology)
1124145420 DR. KARLA MICHELLE STANZ, DMD
Dentist
1013141852 WILLIAM PENN DENTAL P.C.
Dentist (General Practice)
1033447867 DR. KENNETH CHIUSANO
Dentist
1205157922 DR. LUCAS ENRIQUE MANTILLA, D.M.D.
Dentist (General Practice)





Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 1223G0001X Dentist General Practice DS024212-L PA Yes

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1487782454 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 1 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Provider Last Name Legal Name BENNICOFF The last name of the provider. If the provider is an individual, this is the legal name.
4 Provider First Name GARY The first name of the provider, if the provider is an individual.
5 Provider Middle Name LYNN The middle name of the provider, if the provider is an individual.
6 Provider Name Prefix Text DR. The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
7 Provider Credential Text D.D.S. The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
8 Provider First Line Business Practice Location Address 1305 TATAMY RD The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
9 Provider Business Practice Location Address City Name EASTON The city name in the location address of the provider being identified.
10 Provider Business Practice Location Address State Name PA The State code in the location of the provider being identified.
11 Provider Business Practice Location Address Postal Code 180457474 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
12 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
13 Provider Business Practice Location Address Telephone Number 6102522223 The telephone number associated with the location address of the provider being identified.
14 Provider Business Practice Location Address Fax Number 6102524099 The fax number associated with the location address of the provider being identified.
15 Provider Enumeration Date 3/1/2007 The date the provider was assigned a unique identifier (assigned an NPI).
16 Last Update Date 9/2/2008 The date that a record was last updated or changed.
17 Provider Gender Code M The code designating the provider’s gender if the provider is a person.
18 Healthcare Provider Taxonomy Code 1 1223G0001X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
19 Provider License Number 1 DS024212-L The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
20 Provider License Number State Code 1 PA The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
21 Healthcare Provider Primary Taxonomy Switch 1 Y
22 Is Sole Proprietor Y Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No

Download Record

Download this NPI record in Text format: Export

Download this NPI record in Excel (CSV) format: Export

Download this NPI record in XML format: Export




This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.