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1316000581 NPI number — BENJAMIN FREDRICK OGLETREE DDS

NPI Number: 1316000581
Health Care Provider/Practitioner: BENJAMIN FREDRICK OGLETREE DDS

Information about “1316000581” NPI (BENJAMIN FREDRICK OGLETREE DDS) exists in 1316000581 in HTML format HTML  |  1316000581 in plain Text format TXT  |  1316000581 in PDF (Portable Document Format) PDF  |  1316000581 in an XML format XML  formats.

NPI Number : 1316000581 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1316000581",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "OGLETREE",
    "FirstName": "BENJAMIN",
    "MiddleName": "FREDRICK",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "DDS",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "OGLETREE",
    "OtherFirstName": "BENJAMIN",
    "OtherMiddleName": "FREDRICK",
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "DDS",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "2401 5TH ST N # 1",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "COLUMBUS",
    "MailingAddressStateName": "MS",
    "MailingAddressPostalCode": "39705-2005",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "662-328-1825",
    "MailingAddressFaxNumber": "662-328-1825",
    "FirstLinePracticeLocationAddress": "2401 N 5TH STR #1",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "COLUMBUS",
    "PracticeLocationAddressStateName": "MS",
    "PracticeLocationAddressPostalCode": "39705-2005",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "662-328-1825",
    "PracticeLocationAddressFaxNumber": "662-328-1825",
    "EnumerationDate": "12/19/2006",
    "LastUpdateDate": "12/21/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1223G0001X",
        "TaxonomyName": "General Practice Dentistry",
        "LicenseNumber": "1676-75",
        "LicenseNumberStateCode": "MS",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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