Dante a. Banta, M.D., Inc.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

A44079 Issued in CA

Legal business name

DANTE A. BANTA, M.D., INC.

Practice address

875 N Western Ave
Los Angeles, CA 90029-3759

Phone

(323) 461-0777

Fax

(323) 461-8035

NPI assigned

Apr 8, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Dante Atienza Banta, M.D.NPI 1912071085

Title

President

Phone

(323) 461-0777

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Clinica Western Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

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

• Dante Atienza Banta, MD

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1912071085
  Medicare reassignment NPD Authorized official
• Veronica M Banta, MD

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1265692925
  Medicare reassignment NPD

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312243200000",
    "number": "1215100417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 N WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900293759",
            "telephone_number": "323-461-0777",
            "fax_number": "323-461-8035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 N WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900293759",
            "telephone_number": "323-461-0777",
            "fax_number": "323-461-8035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANTE A. BANTA, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-08",
        "last_updated": "2011-08-02",
        "status": "A",
        "authorized_official_last_name": "BANTA",
        "authorized_official_first_name": "DANTE",
        "authorized_official_middle_name": "ATIENZA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-461-0777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A44079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A440791",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinica Western",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Itai Danovitch, ITAI DANOVITCH
• Jalen Dansby, MD
• Stephen Dansiger
• Elena Nicole Dansky
• Zoetania Dantas, MD
• Dante Almendral MD, a Medical Corporation
• Jude Dante
• Kristell Justice V Dantoc
• Sahitya Dantuluri, MD
• Brandon Dantzler

• Primary Care Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.