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NPI Code Detail

MEDICARE: JOHANNA P BENINK DDS

MEDICARE: JOHANNA P BENINK DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist6761CO

General Provider Information

NPI Number : 1518986124
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHANNA P BENINK DDS
Provider Business Mailing Address
First Line : 2111 CHAMPA ST
Second Line :
City : DENVER
State : CO
Zip : 80205-2529
Country : US
Telephone Number : 303-285-5205
Fax Number :
Provider Business Practice Location Address
First Line : 2111 CHAMPA ST
Second Line :
City : DENVER
State : CO
Zip : 80205-2529
Country : US
Telephone Number : 303-291-5165
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 04/13/2012

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Directions to “ JOHANNA P BENINK DDS” Practice Location

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