Provider Demographics
NPI:1558240929
Name:JOHN BENKOVICH DDS MS PA
Entity type:Organization
Organization Name:JOHN BENKOVICH DDS MS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BENKOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-268-1700
Mailing Address - Street 1:1616 FOREST DR STE 7
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21403-1019
Mailing Address - Country:US
Mailing Address - Phone:410-268-1700
Mailing Address - Fax:
Practice Address - Street 1:800 ABRUZZI DR STE F
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:MD
Practice Address - Zip Code:21619-2382
Practice Address - Country:US
Practice Address - Phone:410-643-4499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty