Provider Demographics
NPI:1467197855
Name:ROPHIE, BENJAMIN R (DMD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:R
Last Name:ROPHIE
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 1:3658 SW 24TH AVE APT 104
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-4406
Mailing Address - Country:US
Mailing Address - Phone:727-492-0625
Mailing Address - Fax:
Practice Address - Street 1:6921 W NEWBERRY RD STE B
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4407
Practice Address - Country:US
Practice Address - Phone:352-333-7788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-01
Last Update Date:2022-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLDN27301122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program