Active NPI
Daisuke Bannai, D.D.S.
- General Practice Dentistry
- Roseville, CA
National Provider Identifier
1174680458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 47686
- Practice address
- 406 Sunrise Ave
Suite 240
Roseville, CA 95661-4106 - Phone
- (916) 783-5144
- Fax
- (916) 783-5193
- NPI assigned
- Jan 3, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 47686 | CA | Primary |
Addresses
Primary practice location
406 Sunrise Ave
Suite 240
Roseville, CA 95661-4106
Mailing address
406 Sunrise Ave
Suite 240
Roseville, CA 95661-4106
Phone (916) 783-5144
Medicare participation
Medicare enrollment files- 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
- Opted out of Medicare
- Yes, effective Jun 12, 2018 through Jun 12, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47686 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174680458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "406 SUNRISE AVE",
"address_2": "SUITE 240",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956614106",
"telephone_number": "916-783-5144",
"fax_number": "916-783-5193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "406 SUNRISE AVE",
"address_2": "SUITE 240",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956614106",
"telephone_number": "916-783-5144",
"fax_number": "916-783-5193"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANNAI",
"first_name": "DAISUKE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "47686",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.