DR. JOSEPH SHINE DIBENEDETTO DMD NPI 1790287506

NPI Information

  • NPI: 1790287506
  • Provider Name: DR. JOSEPH SHINE DIBENEDETTO, DMD
  • Classification: Dentist - 1223P0221X
  • Specialization: Pediatric Dentistry
  • Entity Type: Individual
  • Address: 12165 ELM ST
    PRINCESS ANNE, MD
    ZIP 21853
  • Phone: (410) 651-5151

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NPI Details

DR. Joseph Shine Dibenedetto, DMD is a pediatric dentistry dentist in Princess Anne, MD. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. DR. Joseph Shine Dibenedetto, DMD NPI is 1790287506. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

12165 ELM ST
PRINCESS ANNE, MD
ZIP 21853
Phone: (410) 651-5151
Fax: (410) 651-4256

The enumeration date for this NPI number is 3/7/2018 and was last updated on 6/25/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. 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
11223P0221XDentistPediatric DentistryLL834MARYLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1119591300MEDICAIDMARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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