Active NPI
Jason Andrew Banks, DDS
- Dentist
- Elizabeth City, NC
National Provider Identifier
1194929992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 8559
- Practice address
- 1745 City Center Blvd Ste a
Elizabeth City, NC 27909 - Phone
- (252) 331-2304
- NPI assigned
- Jun 14, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 8559 | NC | Primary |
Addresses
Primary practice location
1745 City Center Blvd Ste a
Elizabeth City, NC 27909
Mailing address
1745 City Center Blvd Ste a
Elizabeth City, NC 27909-8953
Phone (252) 331-2304
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8559 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536019200000",
"number": "1194929992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1745 CITY CENTER BLVD STE A",
"city": "ELIZABETH CITY",
"state": "NC",
"postal_code": "279098953",
"telephone_number": "252-331-2304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1745 CITY CENTER BLVD STE A",
"city": "ELIZABETH CITY",
"state": "NC",
"postal_code": "27909",
"telephone_number": "252-331-2304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANKS",
"first_name": "JASON",
"middle_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-14",
"last_updated": "2018-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NC",
"license": "8559",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elizabeth City, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.