DR. MISTY MARIE BENNETT DDS
NPI 1609525757
Dentist - General Practice in Shaw Afb, SC

Q: What is the provider's specialty?

The provider's specialty is Dentist with taxonomy code 1223G0001X and a focus in General Practice.

Active since March 23, 2022

420 POLIFKA DR BLDG 1042, SHAW AFB, SC 29152(803) 895-6951 Get Directions Write a Review

NPPES record last updated: October 11, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Dr. Misty Marie Bennett Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MISTY MARIE BENNETT DDS (NPI 1609525757) is an individual general practice provider in Shaw Afb, South Carolina, licensed in Indiana (12013810A) and active in the NPI registry since March 2022.

NPPES Registry Identity

NPI1609525757

Entity TypeIndividualFemale

Primary Taxonomy1223G0001X

Provider Legal NameDR. MISTY MARIE BENNETTCredential: DDS

Location Address420 POLIFKA DR BLDG 1042Shaw Afb, SC 29152-5100

Mailing Address420 Polifka Dr Bldg 1042Shaw Afb, SC 29152-5100

Phone(803) 895-6951

Sole ProprietorNo

Enumeration DateMarch 23, 2022

Last NPPES UpdateOctober 11, 2024

NPPES CertifiedOctober 11, 2024

✔ NPI 1609525757 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in IN · 12013810A

Definition

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.

420 POLIFKA DR BLDG 1042, Shaw Afb, SC 29152

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