Kathy A Banks, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

17792 Issued in NJ

Practice address

249 S Main St
Unit 4
Barnegat, NJ 08005-2301

Phone

(609) 488-2325

Fax

(609) 488-2342

NPI assigned

Feb 3, 2006

Sex

Female

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Sep 12, 2017 through Sep 12, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1124090212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 LAUREL BLVD",
            "city": "LANOKA HARBOR",
            "state": "NJ",
            "postal_code": "087342720",
            "telephone_number": "609-488-2325",
            "fax_number": "609-488-2342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 S MAIN ST",
            "address_2": "UNIT 4",
            "city": "BARNEGAT",
            "state": "NJ",
            "postal_code": "080052301",
            "telephone_number": "609-488-2325",
            "fax_number": "609-488-2342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKS",
        "first_name": "KATHY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-03",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "17792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Barnegat, NJ
• Providers in Barnegat, NJ by specialty
• Oral and Maxillofacial Surgery (Dentist) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.