Provider Demographics
NPI:1376525527
Name:CILENTO, BENJAMIN WEST (MD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:WEST
Last Name:CILENTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2940 FM 2920 RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-3427
Mailing Address - Country:US
Mailing Address - Phone:346-413-9313
Mailing Address - Fax:281-901-5334
Practice Address - Street 1:2940 FM 2920 RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-3427
Practice Address - Country:US
Practice Address - Phone:346-413-9313
Practice Address - Fax:281-901-5334
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN5629207YS0123X, 207Y00000X, 207YS0123X
WA43734207YS0123X, 207YX0007X, 207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
No207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB102309OtherMEDICARE PTAN
TXTXB107759OtherMEDICARE PTAN
TXTXB107760OtherMEDICARE PTAN