Provider Demographics
NPI:1346250818
Name:PI, BENJAMIN Y (DDS)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:Y
Last Name:PI
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 1:439 S EUCLID ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92802-1229
Mailing Address - Country:US
Mailing Address - Phone:714-535-2888
Mailing Address - Fax:714-535-2022
Practice Address - Street 1:439 S EUCLID ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92802-1229
Practice Address - Country:US
Practice Address - Phone:714-535-2888
Practice Address - Fax:714-535-2022
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28792122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist