Individual provider Active NPI

Barron Banks, DDS

  • Dentist
  • Jacksonville, FL
National Provider Identifier
1225442320
Registry record updated Jan 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN 21320 Issued in FL
Practice address
10950 San Jose Blvd Ste 64
Jacksonville, FL 32223-6671
Phone
(904) 260-4244
NPI assigned
Jun 17, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN 21320 FL Primary

Addresses

Primary practice location

10950 San Jose Blvd Ste 64
Jacksonville, FL 32223-6671

Mailing address

10950 San Jose Blvd Ste 64
Jacksonville, FL 32223-6671

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160121001330 FL Order and Referring Only - DentistPractitioner - Dentist 2860795036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 21320FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Coast Dental P.a. Dentist Past Accepting new patients
Coast Dental P.a. Dentist PastSince Jun 22, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484179200000",
    "number": "1225442320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10950 SAN JOSE BLVD STE 64",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322236671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10950 SAN JOSE BLVD STE 64",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322236671",
            "telephone_number": "904-260-4244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKS",
        "first_name": "BARRON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-17",
        "last_updated": "2017-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 21320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.