Dr. Brent S. Banner

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D3028 Issued in ID

Legal business name

DR. BRENT S. BANNER

Practice address

1010 E Main St
Burley, ID 83318-2045

Phone

(208) 678-5597

NPI assigned

Mar 6, 2008

Last updated

Mar 6, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brent Banner

Title

Owner

Phone

(208) 678-5597

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204761600000",
    "number": "1437329356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 EAST MAIN",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 E MAIN ST",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182045",
            "telephone_number": "208-678-5597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. BRENT S. BANNER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-06",
        "last_updated": "2008-03-06",
        "status": "A",
        "authorized_official_last_name": "BANNER",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-678-5597",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D3028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Davis
• Dennis Michaelson D.M.D., Ms
• Matthew David Detemple, D.O.
• Cami Dixon, RDN
• Mark A Dowdle, MD
• Charles Buchanan Drew, DDS
• Oliver Joseph Droefenu, PHARMD
• Trevor Dschaak
• Mark Lee Dunlap, N.D., C.A.C., L.M.T
• Tyler Earl, COTA/L

• General Practice Dentistry in Burley, ID
• Providers in Burley, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; 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.