Healthcare Provider Details

I. General information

NPI: 1740103126
Provider Name (Legal Business Name): BENJAMIN ROY DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2945 NEW BERN AVE
RALEIGH NC
27610-1213
US

IV. Provider business mailing address

216 MT EVANS DR
DURHAM NC
27705-2871
US

V. Phone/Fax

Practice location:
  • Phone: 919-834-4932
  • Fax:
Mailing address:
  • Phone: 704-754-7743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14937
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: