Healthcare Provider Details

I. General information

NPI: 1851127682
Provider Name (Legal Business Name): PAOLA BENEFO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2024
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 PARNASSUS AVE
SAN FRANCISCO CA
94143-2210
US

IV. Provider business mailing address

325 27TH ST UNIT 638
OAKLAND CA
94612-3253
US

V. Phone/Fax

Practice location:
  • Phone: 415-502-5800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN10001260
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: