Provider Demographics
NPI:1710183256
Name:NAGEL, BENJAMIN JAMES (DDS)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:JAMES
Last Name:NAGEL
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 1:12600 PRAIRIE DR
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50323-2378
Mailing Address - Country:US
Mailing Address - Phone:515-243-9677
Mailing Address - Fax:
Practice Address - Street 1:3700 WESTOWN PKWY
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1029
Practice Address - Country:US
Practice Address - Phone:515-225-6742
Practice Address - Fax:515-224-1560
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA08262122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist