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NPI Code Detail

MEDICARE: BENJAMIN ANDERS D.D.S., M.D.S.

MEDICARE: BENJAMIN ANDERS D.D.S., M.D.S.
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
1122300000XDentist10297SC
2122300000XDentist10380NC
3122300000XDentist060991NY
41223X0400XOrthodontics and Dentofacial Orthopedics Dentistry10480SC

General Provider Information

NPI Number : 1841648524
Entity Type Code : Individual
Provider Name (Legal Business Name) : BENJAMIN ANDERS D.D.S., M.D.S.
Provider Business Mailing Address
First Line : 4400 DORCHESTER RD
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29405-6849
Country : US
Telephone Number : 843-590-3054
Fax Number :
Provider Business Practice Location Address
First Line : 4400 DORCHESTER RD
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29405-6849
Country : US
Telephone Number : 843-590-3054
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2016
Last Update Date : 05/18/2023

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