Healthcare Provider Details

I. General information

NPI: 1609496884
Provider Name (Legal Business Name): BENJAMIN JAMES VAN ESS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2020
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

T-4323A MEDICAL CENTER NORTH 1161 21ST AVENUE SOUTH
NASHVILLE TN
37232-2596
US

IV. Provider business mailing address

T-4323A MEDICAL CENTER NORTH 1161 21ST AVENUE SOUTH
NASHVILLE TN
37232-2596
US

V. Phone/Fax

Practice location:
  • Phone: 615-343-9404
  • Fax:
Mailing address:
  • Phone: 615-343-9404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number1002298
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: