Jerome a Bannister DDS Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

38253 Issued in CA

Legal business name

JEROME A BANNISTER DDS INC

Practice address

4370 Palm Ave
Ste C
San Diego, CA 92154-1760

Phone

(619) 428-8682

Fax

(619) 428-1043

NPI assigned

Oct 19, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Lizbeth Chavez

Title

Office Manager

Phone

(619) 428-8682

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

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

• Jerome A Bannister, DDS

  • General Practice Dentistry
  • San Diego, CA
  • NPI 1922024934
  NPD (past)
• Michael Ha-Quang Ho, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Lakewood, CA
  • NPI 1912146598
  NPD (past)
• Marc Geronimo, DDS

  • General Practice Dentistry
  • Phoenix, AZ
  • NPI 1255406682
  NPD (past)

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154310472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4370 PALM AVE",
            "address_2": "STE C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921541760",
            "telephone_number": "619-428-8682",
            "fax_number": "619-428-1043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 PALM AVE",
            "address_2": "STE C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921541760",
            "telephone_number": "619-428-8682",
            "fax_number": "619-428-1043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEROME A BANNISTER DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHAVEZ",
        "authorized_official_first_name": "LIZBETH",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "619-428-8682",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "38253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI CAL",
            "identifier": "B38253 01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jill Jergens
• Jason A Jergensen, DO
• Nujim A Jerjees, M.D
• Lori Mildred Jerman, LMFT
• Danielle Jernigan
• Jerome C Hall M D Inc
• Jerome S Litvinoff MD a Medical Corporation
• John Robert Jerome, DDS
• Nicholas Joseph Jerrard, MD
• Demetrius Jerrell, SUDRC

• General Practice Dentistry in San Diego, CA
• Providers in San Diego, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.