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General NPI Number Information
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NPI Number | 1679426266
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Entity Type | Organization
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Legal Business Name | DEJL
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Dates
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Enumeration Date | 02/16/2026
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Last Update Date | 02/16/2026
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Provider Practice Location Address
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Address Line | 1858 STAFFORD RD
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City | PLAINFIELD
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State | IN
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Zip | 46168-2339
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Country | US
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Telephone | 970-520-1721
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Fax |
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Provider Business Mailing Address
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Address Line | 5204 HESSEN DR
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City | PLAINFIELD
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State | IN
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Zip | 46168-8423
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Country | US
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Telephone | 970-520-1721
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | EMILY BENSON
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Credential | DDS
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Telephone | 970-520-1721
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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