Individual provider Active NPI

Dalton Van Banh, MD, PHD

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1245027515
Registry record updated Jun 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2025021077 Issued in MO
Practice address
1 Barnes Jewish Plaza
Saint Louis, MO 63110-1020
Phone
(314) 359-8333
NPI assigned
Apr 21, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2025021077 MO Primary

Addresses

Primary practice location

1 Barnes Jewish Plaza
Saint Louis, MO 63110-1020

Mailing address

660 S Euclid Ave
Ms #8121-0022-07
Saint Louis, MO 63110-1020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250627003015 MO Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4284147778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2025021077MOMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1745193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750550400000",
    "number": "1245027515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "address_2": "MS #8121-0022-07",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARNES JEWISH PLAZA",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101020",
            "telephone_number": "314-359-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANH",
        "first_name": "DALTON",
        "middle_name": "VAN",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-21",
        "last_updated": "2025-06-22",
        "certification_date": "2025-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2025021077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.