Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1710476924 Individual Practitioner Male Practitioner

Dr. Benjamin Graham Bacon , DDS

Dentist - General Practice • Vandenberg Afb, CA

Professional Overview & Biography Verified Profile Summary

Dr. Benjamin Bacon, DDS is a registered healthcare professional specializing in Dentist - General Practice in Vandenberg Afb, CA. Practice services are available at 338 S DAKOTA AVE BLDG 13850 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

338 S Dakota Ave Bldg 13850

Vandenberg Afb, CA 934376307

Telephone 3618159929
Associated Practice Facility / Clinic
🏢 30th Medgrp-Vandenberg Facility NPI 1043626419

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Vandenberg Afb, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
5 Specialists

Practicing in Vandenberg Afb, CA (18734 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-07-27
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License NC 12605

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Dentist

NUCC Taxonomy Code: 122300000X

State License UT 10867252-9921

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
Jordan Sullivan , RN

Registered Nurse

NPI 1073318499

Registered Nurse

NPI 1518490135

Doctor of Osteopathic Medicine (D.O.)

Brigette Lugo

Dental Hygienist

NPI 1801634076
Dr. Peter Scott , MD

Family Medicine

NPI 1831575018

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
📍
Updated Business Mailing Address July 27, 2025

Registered at 817 BASS LANDING PL, GREENSBORO, NC 274553440 (Tel: 3618159299)

📍
Updated Practice Location July 24, 2019

Registered at 338 S DAKOTA AVE BLDG 13850, VANDENBERG AFB, CA 934376307 (Tel: 3618159929)

📍
Updated Business Mailing Address July 24, 2019

Registered at 338 S DAKOTA AVE BLDG 13850, VANDENBERG AFB, CA 934376307

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 24, 2019

Dentist (License #10867252-9921 in UT)

NPI Profile Active May 02, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location May 02, 2018

Registered at 806 LAUREL DR, FORT WALTON BEACH, FL 325472913 (Tel: 3618159929)

📍
Updated Business Mailing Address May 02, 2018

Registered at 806 LAUREL DR, FORT WALTON BEACH, FL 325472913 (Tel: 3618159929)

👤
Provider Name / Credentials Updated May 02, 2018

Recorded as BENJAMIN BACON, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 02, 2018

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration May 02, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1710476924
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 02, 2018
Last Update: July 27, 2025
Sole Proprietor: No

Mailing Address

817 Bass Landing Pl

Greensboro, NC 274553440

Phone: 3618159299

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.