Jason Philip Bansch, D.M.D.
Individual provider Active NPI General Practice Dentistry · Drexel Hill, PA
NPI 1407052301 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1407052301
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DS037243 (PA)
- Practice address
- 1021 Pontiac Rd
Drexel Hill, PA 19026-4816 - Phone
- (610) 449-2001
- NPI assigned
- Jun 26, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS037243 | PA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Drexel Hill Dental | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS037243 | PA | Yes |
Addresses
Primary practice location
1021 Pontiac Rd
Drexel Hill, PA 19026-4816
Mailing address
1732 Hawthorne Ave
Havertown, PA 19083-1627
Phone (610) 547-5818
Other providers in Drexel Hill, PA
- Christopher Aviso
- Az Medical Director PLLC
- Syreeta Bailey-Wilson
- Kimberly Ann Balogun
- Olayinka Balogun
- Annmarie Barber
- Sonia Stella Barbosa-Ruiz
- Chioma I Barco- Ekeke
- Tim Barksdale
- Asekia Barmont
All providers in Drexel Hill, PA · General Practice Dentistry in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.