Provider Demographics
NPI:1972201473
Name:RECKMEYER, BENJAMIN ANDREW (DDS)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:ANDREW
Last Name:RECKMEYER
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 1:428 HOUSTON ST
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-6136
Mailing Address - Country:US
Mailing Address - Phone:857-760-0977
Mailing Address - Fax:
Practice Address - Street 1:428 HOUSTON ST
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-6136
Practice Address - Country:US
Practice Address - Phone:857-760-0977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-23
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS62083122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist