Laci C Banks

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

2023021409 Issued in MO

Practice address

1300 N Oakland Ave Ste B
Bolivar, MO 65613-3008

Phone

(417) 326-6061

NPI assigned

Oct 30, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bolivar Smiles Dentistry, LLC

  • General Practice Dentistry
  • Bolivar, MO
  • NPI 1811622525
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1698624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1013780394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "372 SPRINGFIELD RD",
            "city": "BUFFALO",
            "state": "MO",
            "postal_code": "656224120",
            "telephone_number": "417-733-5605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N OAKLAND AVE STE B",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133008",
            "telephone_number": "417-326-6061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKS",
        "first_name": "LACI",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-30",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MO",
            "license": "2023021409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Associates in Medicine, Inc
• Stephanie Marie Aug, PA
• Azare
• Jason M Bailey, D.O.
• Harcharan Bains, MD
• Deanna Lynn Barklage
• Brandon Barnes, FNP
• Brent Allen Bartgis, DO
• Jason A Barzee, DDS
• Ashley M Batson

• All providers in Bolivar, MO
• Dental Hygienist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.