BENJAMIN R BUNTROCK DMD
NPI 1023372265
Dentist in Detroit Lakes, MN
About Benjamin R Buntrock Dmd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BENJAMIN R BUNTROCK DMD (NPI 1023372265) is an individual dentist in Detroit Lakes, Minnesota, licensed in Minnesota (D13140) and active in the NPI registry since July 2012. He has opted out of Medicare through March 18, 2028 and remains eligible to order and refer.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Benjamin R Buntrock Dmd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 18, 2016 through March 18, 2028.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 56501 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Benjamin Buntrock's NPI number?
The NPI number for Benjamin Buntrock is 1023372265. It was assigned to this individual provider in the NPPES registry on July 3, 2012.
Where is Benjamin Buntrock located?
Benjamin Buntrock practices at 1106 W River Rd, Detroit Lakes, MN 56501. The listed phone number is (218) 846-1900.
What is Benjamin Buntrock's specialty?
The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.
Is Benjamin Buntrock enrolled in Medicare?
No. Benjamin Buntrock has opted out of Medicare through March 18, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.
When was this NPI record last updated?
The NPPES record for Benjamin Buntrock was last updated on July 3, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Benjamin R Buntrock, DMD · NPI 1023372265
Dentist provider in Detroit Lakes, Minnesota. Individual provider, active in the CMS NPPES registry since July 3, 2012.
## Identity
- **NPI:** 1023372265 (Entity type: Individual)
- **Enumerated:** July 3, 2012
- **Primary specialty:** Dentist · taxonomy 122300000X
- **State license:** D13140 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 1106 W RIVER RD, Detroit Lakes, MN 56501-2723
- **Phone:** (218) 846-1900
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through March 18, 2028); services are provided under private contract
## Record status
- **NPPES last updated:** July 3, 2012
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Source: [NPI Profile](https://npiprofile.com/npi/1023372265) · Data from the CMS NPPES public registry.