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Active NPI 1801182704 Individual Practitioner Male Practitioner

Dr. Benjamin Earl Dewaal , DDS

Dentist - General Practice • Potosi, MO

Professional Overview & Biography Verified Profile Summary

Dr. Benjamin Dewaal, DDS is a registered healthcare professional specializing in Dentist - General Practice in Potosi, MO. Practice services are available at 1 SOUTHTOWNE DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1 Southtowne Dr

Potosi, MO 636645729

Telephone 5734388401
Fax 5734388402
Associated Practice Facility / Clinic
🏢 Genoa Healthcare Llc Facility NPI 1013272103

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Potosi, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 9.5 Yrs
Regional Practice Density
5 Specialists

Practicing in Potosi, MO (2113 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

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License MO 2011017964

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.

Practice Associates & Co-Workers

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

3 Associated Practitioners
Audra O'neal , RDH

Dental Hygienist

NPI 1174890909

Registered Dental Hygienist

Dr. Matthew Standridge , DDS

Dentist - Dental Public Health

NPI 1255650529

Doctor of Dental Surgery

NPI 1346698396

Doctor of Dental Surgery

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active June 20, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location June 20, 2011

Registered at 1 SOUTHTOWNE DR, POTOSI, MO 636645729 (Tel: 5734388401)

📍
Updated Business Mailing Address June 20, 2011

Registered at 1 SOUTHTOWNE DR, POTOSI, MO 636645729 (Tel: 5734388401)

👤
Provider Name / Credentials Updated June 20, 2011

Recorded as BENJAMIN DEWAAL, D.D.S.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 20, 2011

Dentist (License #2011017964 in MO)

🟢
Initial NPI Registration & Enumeration June 20, 2011

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: 1801182704
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 20, 2011
Last Update: June 20, 2011
Sole Proprietor: No

Mailing Address

1 Southtowne Dr

Potosi, MO 636645729

Phone: 5734388401

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.