NPIMap

Organization Active NPI

Dr. Cynthia C. Banderet, DMD, PC

  • Dental Clinic/Center
  • Belleville, IL
National Provider Identifier
1679134829
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
DR. CYNTHIA C. BANDERET, DMD, PC
Practice address
2630 Mascoutah Ave.
Suite a
Belleville, IL 62221
Phone
(618) 234-8411
NPI assigned
Jun 27, 2019
Last updated
Jun 27, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
DR. CYNTHIA C. BANDERET, DMD, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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

Authorized official

Name
Dr. Cynthia Banderet, DMDNPI 1760529333
Title
Owner/Dentist
Phone
(618) 234-8411

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

2630 Mascoutah Ave.
Suite a
Belleville, IL 62221

Mailing address

2630 Mascoutah Ave.
Suite a
Belleville, IL 62221
Phone (618) 234-8411

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL office@orcharddentalcare.com

National Provider Directory

National Provider Directory
Part of
Dr Cynthia C Banderet DMD PC

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561593600000",
    "number": "1679134829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 MASCOUTAH AVE.",
            "address_2": "SUITE A",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "62221",
            "telephone_number": "618-234-8411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 MASCOUTAH AVE.",
            "address_2": "SUITE A",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "62221",
            "telephone_number": "618-234-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. CYNTHIA C. BANDERET, DMD, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DR. CYNTHIA C. BANDERET, DMD, PC",
        "enumeration_date": "2019-06-27",
        "last_updated": "2019-06-27",
        "status": "A",
        "authorized_official_last_name": "BANDERET",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "618-234-8411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "office@orcharddentalcare.com",
            "affiliation": "N",
            "address_1": "2630 Mascoutah Ave.",
            "address_2": "Suite A",
            "city": "Belleville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "62221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; 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.