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BENTON MODERN DENTISTRY, INC.
NPI 1871470922
Dentist - General Practice in Winchester, CA

Active since August 20, 2025CLIA 05D2343036 · Waiver
30890 BENTON RD, WINCHESTER, CA 92596(714) 845-8500 Get Directions Write a Review

NPPES record last updated: August 20, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Benton Modern Dentistry, Inc. NPPES

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

BENTON MODERN DENTISTRY, INC. (NPI 1871470922) is a healthcare organization registered as a general practice in Winchester, California and active in the NPI registry since August 2025. The organization holds a CLIA Waiver certificate valid through April 29, 2028 and lists Alexander Pollock, Owner, as its authorized official.

NPPES Registry Identity

NPI1871470922
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameBENTON MODERN DENTISTRY, INC.
Location Address30890 BENTON RDWinchester, CA 92596-6098
Mailing AddressPo Box 660041Dallas, TX 75266-0041
Phone(714) 845-8500
Organization SubpartNo
Authorized OfficialAlexander PollockOwner · (714) 845-8500
Enumeration DateAugust 20, 2025
NPPES CertifiedAugust 20, 2025
✔ NPI 1871470922 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
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.
30890 BENTON RD, Winchester, CA 92596
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2343036

Benton Modern Dentistry · Winchester, CA
Active · expires Apr 29, 2028
CLIA Number05D2343036
Laboratory TypePractitioner Other
Certificate Effective DateApril 30, 2026
Certificate Expiration DateApril 29, 2028
Laboratory DirectorAlexander Pollock
Laboratory Phone(951) 592-3447
Laboratory LocationBenton Modern Dentistry30890 Benton Rd, Ste 101, Winchester, CA 92596
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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 Benton Modern Dentistry, Inc.'s NPI number?

The NPI number for Benton Modern Dentistry, Inc. is 1871470922. It was assigned to this organization in the NPPES registry on August 20, 2025.

Where is Benton Modern Dentistry, Inc. located?

Benton Modern Dentistry, Inc. is located at 30890 Benton Rd, Winchester, CA 92596. The listed phone number is (714) 845-8500.

What is Benton Modern Dentistry, Inc.'s specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Does Benton Modern Dentistry, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2343036) is associated with this NPI, valid through April 29, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Benton Modern Dentistry, Inc. was last updated on August 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.