Provider Demographics
NPI:1841422557
Name:TINGEY, BENJAMIN TODD (DMD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:TODD
Last Name:TINGEY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8400 OSUNA RD NE
Mailing Address - Street 2:1-A
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2087
Mailing Address - Country:US
Mailing Address - Phone:505-275-0500
Mailing Address - Fax:505-275-0784
Practice Address - Street 1:8400 OSUNA RD NE
Practice Address - Street 2:1-A
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-2087
Practice Address - Country:US
Practice Address - Phone:505-275-0500
Practice Address - Fax:505-275-0784
Is Sole Proprietor?:No
Enumeration Date:2009-08-13
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD3651122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist