Dental Corporation of Wade Melvin Banner DMD Inc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DENTAL CORPORATION OF WADE MELVIN BANNER DMD INC

Practice address

929 Foothill Blvd Ste B
La Verne, CA 91750-3223

Phone

(909) 973-0099

NPI assigned

Dec 2, 2022

Last updated

Dec 2, 2022By 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

Wade Banner, DMDNPI 1952718702

Title

Owner

Phone

(909) 973-0099

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Wade M Banner, D.M.D.

  • General Practice Dentistry
  • Glendora, CA
  • NPI 1952718702
  NPD Authorized official

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

{
    "created_epoch": "1669939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669939200000",
    "number": "1669182333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 FOOTHILL BLVD STE B",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917503223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 FOOTHILL BLVD STE B",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917503223",
            "telephone_number": "909-973-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL CORPORATION OF WADE MELVIN BANNER DMD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-02",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A",
        "authorized_official_last_name": "BANNER",
        "authorized_official_first_name": "WADE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-973-0099",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanna Delarosa
• Adolph Thomas Delgado, MFTI
• Demian Choi DDS, Inc (Prizm Dental)
• Dental Care of la Verne
• Dental Corporation of Louis Z. Stromberg, DDS (La Verne Dental Group)
• Emma Depew, M.S. CCC-SLP
• Diane Boval DDS a Professional Dental Corp (Gold Coast Dental)
• Mini Diblasi, M.S.
• Kim Dinh, PA-C
• Donald J Guido OD Inc (La Verne Optometry)

• Dental Clinic/Center in La Verne, CA
• Providers in La Verne, CA by specialty
• Dental Clinic/Center in California

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