Provider Demographics
NPI:1073715785
Name:BENYAMINI, DAN P (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAN
Middle Name:P
Last Name:BENYAMINI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 SAN YSIDRO DR
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-1518
Mailing Address - Country:US
Mailing Address - Phone:310-285-9901
Mailing Address - Fax:213-484-8001
Practice Address - Street 1:1826 W 7TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-4102
Practice Address - Country:US
Practice Address - Phone:213-484-6660
Practice Address - Fax:213-484-8001
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46168122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG92125-01OtherDENTICAL