Thomas M. Banta, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8772 Issued in IN

Practice address

1413 W Votaw St
Portland, IN 47371-9501

Phone

(260) 726-7822

Fax

(260) 726-3513

NPI assigned

Jan 10, 2006

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

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

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Thomas M. Banta, D.D.S., PC

  • General Practice Dentistry
  • Portland, IN
  • NPI 1790409092
  NPD Authorized official
• Vormohr Family Dentistry LLC

  • General Practice Dentistry
  • Portland, IN
  • NPI 1922713668
  NPD (past)

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1407835382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2786 S BUTTERNUT CREEK DR",
            "city": "PORTLAND",
            "state": "IN",
            "postal_code": "473718740",
            "telephone_number": "260-726-7822",
            "fax_number": "260-726-3513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 W VOTAW ST",
            "city": "PORTLAND",
            "state": "IN",
            "postal_code": "473719501",
            "telephone_number": "260-726-7822",
            "fax_number": "260-726-3513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANTA",
        "first_name": "THOMAS",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "8772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Americare Living Center of Portland
• Harold Shane Anderson
• Heidi Augsburger
• Brittany Michelle Auker, PHARMACIST
• Carrie Elizabeth Baldwin, FNP
• Jeffrey William Barr, MD
• Courtney Bible, PT
• Sophia R Binkley-Timmerman, LCAC, LMHC
• Tricia Blakely, LCSW
• Mandy Jean Boeckman, FNP

• General Practice Dentistry in Portland, IN
• Providers in Portland, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.