MARK BENAVIDES D.D.S., P.C. (NPI# 1235201344) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235201344 |
| Entity Type | Organization |
| Organization Name | MARK BENAVIDES D.D.S., P.C. |
| Practice Address |
1703 Polaris Cir Ottawa IL 61350-1683 |
| Practice Telephone | 8154340152 |
| Mailing Telephone | 8154340152 |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2013-12-17 |
| Authorized Official Name | MARK BENAVIDES (OWNER) |
| Authorized Official Telephone | 8154340152 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
0019-20337 | IL | Dental Providers |
| Street Address |
1703 POLARIS CIR |
| City | OTTAWA |
| State | IL |
| Zip Code | 61350-1683 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043216625 | Jeffrey A. Crowhurst | Podiatrist | 1703 Polaris Cir, Ottawa, IL 61350-1683 | 2005-06-28 |
| 1851841407 | Brittany M Jones Dpm LLC | Podiatrist | 1703 Polaris Cir, Suite 4, Ottawa, IL 61350-1683 | 2016-10-06 |
| 1801233606 | Mark Benavides | Dentist | 1703 Polaris Cir, Suite 3, Ottawa, IL 61350-1683 | 2013-06-03 |
| 1780848911 | Brittany Marie Jones | Podiatrist | 1703 Polaris Cir, Suite 4, Ottawa, IL 61350-1683 | 2008-07-16 |
| 1619146016 | Dr Nicholas M Tabor IIi Dpm | Podiatrist | 1703 Polaris Cir, Ottawa, IL 61350-1683 | 2008-02-29 |
| 1235167602 | Thomas Patrick Rooney | Dentist | 1703 Polaris Cir, Ottawa, IL 61350-1683 | 2006-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306336359 | Yulandist Jeannie Brown | Licensed Practical Nurse | 617 Columbus St, Ottawa, IL 61350 | 2018-05-15 |
| 1881071272 | Ashlee Herbold | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1718 N 2525th Rd, Ottawa, IL 61350 | 2015-05-05 |
| 1053702365 | Wanda Rohl | Social Worker | 3735 E 1453 Rd, Ottawa, IL 61350 | 2015-02-09 |
| 1538550868 | Erin Rose Boe | Physical Therapist | 2872 Columbus St, Unit 300, Ottawa, IL 61350 | 2015-02-09 |
| 1346572757 | Rebecca Samolitis | Counselor | 116 W Lafayette St, Suite 8, Ottawa, IL 61350 | 2010-02-10 |
| 1235383266 | Timothy I Miller O.d. P.C. | Optometrist | 107 E. Mckinley Rd., Ottawa, IL 61350 | 2008-11-04 |
| 1427204676 | Leo John Meagher | Counselor | 218 West Madison St, Ottawa, IL 61350 | 2008-08-07 |
| 1598938755 | Radiation Oncology of Northern Illinois LLC | Radiology | 1200 Starfire Dr, Ottawa, IL 61350 | 2008-04-09 |
| 1154538510 | Serenityonwheels, Inc. | Counselor | Serenity On Wheels, Inc. 630 Columbus Street, Ste # 214, Ottawa, IL 61350 | 2007-05-16 |
| 1205040904 | Dixie Devry | Occupational Therapist | 2532 Reynolds Manor, Ottawa, IL 61350 | 2007-05-10 |
| Find all providers in zip 61350 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578773313 | Thomas Wesley Miller | Dentist | 111 W Glover St, Ottawa, IL 61350-3931 | 2007-05-23 |
| 1346453636 | John C Harbeck Dds PC | Dentist | 1210 W Madison St, Ottawa, IL 61350 | 2007-05-07 |
| 1265650691 | Robert William Schmidt | Dentist | 333 E Norris Dr, Ottawa, IL 61350-1518 | 2007-04-23 |
| 1447302773 | Hunter Clark Davis | Dentist | 230 W. Main St, Ottawa, IL 61350 | 2007-01-17 |
| 1275697666 | William Curtis Vesely | Dentist | 111 E Mckinley Rd, Ottawa, IL 61350-4801 | 2006-12-20 |
| 1821189606 | Lex E Gislar | Dentist | 113 E 11th St, Ottawa, KS 66067-3501 | 2006-09-27 |
| 1750489860 | David F. Poeppelman | Dentist | 1808 N Perry St, Ottawa, OH 45875-1129 | 2006-09-20 |
| 1669570263 | John Michael Conness | Dentist | 1704 Polaris Cir Ste 1, Ottawa, IL 61350-1774 | 2006-09-20 |
| 1225147937 | David Lee Meling | Dentist | 1704 Polaris Cir, Ottawa, IL 61350-1773 | 2006-08-29 |
| 1740299627 | Kevin Michael Cook | Dentist | 1404 Aquarius Cir, Ottawa, IL 61350-8914 | 2006-08-07 |
| Find all providers in OTTAWA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.