Healthcare Provider Details

I. General information

NPI: 1902043292
Provider Name (Legal Business Name): BENJAMIN KOREN, D.D.S. V, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2009
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 S MADISON BLVD
ROXBORO NC
27573-5464
US

IV. Provider business mailing address

347 S MADISON BLVD
ROXBORO NC
27573-5464
US

V. Phone/Fax

Practice location:
  • Phone: 919-528-0800
  • Fax: 888-818-4195
Mailing address:
  • Phone: 336-599-1349
  • Fax: 704-823-6367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6997
License Number StateNC

VIII. Authorized Official

Name: AMANDA GROESCHEL
Title or Position: DIRECTOR
Credential:
Phone: 704-978-9800