Provider Demographics
NPI:1699244210
Name:BENJAMIN MCCARTY DMD PLLC
Entity type:Organization
Organization Name:BENJAMIN MCCARTY DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:SIMON
Authorized Official - Last Name:MCCARTY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:757-440-1360
Mailing Address - Street 1:1170 LEXAN AVE STE 187
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23508-1237
Mailing Address - Country:US
Mailing Address - Phone:757-440-1360
Mailing Address - Fax:
Practice Address - Street 1:1170 LEXAN AVE STE 187
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23508-1237
Practice Address - Country:US
Practice Address - Phone:757-440-1360
Practice Address - Fax:757-440-1361
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATLANTIC DENTAL CARE, PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty