Provider Demographics
NPI:1538593223
Name:CHAN, BENJAMIN MING FEI (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:MING FEI
Last Name:CHAN
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1 NASSAU ST
Mailing Address - Street 2:UNIT 2103
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-1542
Mailing Address - Country:US
Mailing Address - Phone:401-334-3070
Mailing Address - Fax:
Practice Address - Street 1:2359 MENDON RD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-3707
Practice Address - Country:US
Practice Address - Phone:401-334-3070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18558341223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics