Sucheta Bansal

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS043670 Issued in PA

Practice address

400 W Allegheny Ave
Philadelphia, PA 19133-3614

Phone

(215) 291-9200

NPI assigned

Jun 2, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1654128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1275272528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1419 W ALLEGHENY AVE APT 502",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191321711",
            "telephone_number": "215-444-3624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W ALLEGHENY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191333614",
            "telephone_number": "215-291-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANSAL",
        "first_name": "SUCHETA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-02",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS043670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kraig Y Bano, MPT CHT
• Esha Bansal, MD, MPH
• Nikhil Deep Bansal, OD
• Pallavi Bansal, DMD
• Sanya Bansal, MD
• Jeanamarie Banta, PT, DPT
• Walter E Bantom III, M.D.
• Jasmin Banton, DO
• Alicia Bao
• Kehan Bao

• General Practice Dentistry in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.