Susan Kay Banta DDS Ms PA

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

SUSAN KAY BANTA DDS MS PA

Practice address

1611 Doctors Circle
Wilmington, NC 28401

Phone

(910) 772-9770

Fax

(910) 772-1553

NPI assigned

Dec 19, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Susan Kay Banta, DDS MSNPI 1528275799

Title

President

Phone

(910) 772-9770

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susan Kay Banta

  • Periodontics
  • Wilmington, NC
  • NPI 1528275799
  NPD (past) Authorized official

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197849600000",
    "number": "1124181110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 DOCTORS CIRCLE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "28401",
            "telephone_number": "910-772-9770",
            "fax_number": "910-772-1553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 DOCTORS CIRCLE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "28401",
            "telephone_number": "910-772-9770",
            "fax_number": "910-772-1553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN KAY BANTA DDS MS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-12-17",
        "status": "A",
        "authorized_official_last_name": "BANTA",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-772-9770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS MS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sharonda Sutton-Smith, RBT
• Audrey Lynn Sutton-Surak, DO
• Morgan Sutton
• William R Sutton, MD
• Suzanne K. Hentz M.D., Gynecology, PC

• Periodontics in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Periodontics in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; 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.