Healthcare Provider Details

I. General information

NPI: 1881034023
Provider Name (Legal Business Name): KIMBERLY ANN BENSON DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2013
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2105 PRINCESS ANNE ROAD SUITE 108
VIRGINIA BEACH VA
23456
US

IV. Provider business mailing address

2105 PRINCESS ANNE ROAD SUITE 108
VIRGINIA BEACH VA
23456
US

V. Phone/Fax

Practice location:
  • Phone: 757-301-3945
  • Fax:
Mailing address:
  • Phone: 757-301-3945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number60988
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number2013018619
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: