NPIMap

Organization Active NPI

Banich Family Dental

  • General Practice Dentistry
  • Colville, WA
National Provider Identifier
1730497983
Registry record updated Sep 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
606128-00-5 Issued in WA
Legal business name
BANICH FAMILY DENTAL
Practice address
775 S Main St
Ste C
Colville, WA 99114-2514
Phone
(509) 684-4586
Fax
(509) 685-1043
NPI assigned
Sep 22, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2010

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

Authorized official

Name
Miss Julie Ann Mace
Title
Office Manager
Phone
(509) 684-4586

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 606128-00-5 WA Primary

Addresses

Primary practice location

775 S Main St
Ste C
Colville, WA 99114-2514

Mailing address

775 S Main St
Ste C
Colville, WA 99114-2514
Phone (509) 684-4586

Other identifiers 1

IdentifierTypeStateIssuer
5513106MedicaidWA

Other names 1

  • Steven G. Banich DDS PLLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Banich Banich PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

775 S Main St
Ste C
Colville, WA 99114
Phone (509) 684-4586

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1285113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285113600000",
    "number": "1730497983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 S MAIN ST",
            "address_2": "STE C",
            "city": "COLVILLE",
            "state": "WA",
            "postal_code": "991142514",
            "telephone_number": "509-684-4586",
            "fax_number": "509-685-1043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 S MAIN ST",
            "address_2": "STE C",
            "city": "COLVILLE",
            "state": "WA",
            "postal_code": "991142514",
            "telephone_number": "509-684-4586",
            "fax_number": "509-685-1043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANICH FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-22",
        "last_updated": "2010-09-22",
        "status": "A",
        "authorized_official_last_name": "MACE",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "509-684-4586",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "606128-00-5",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5513106",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Steven G. Banich DDS PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2010; 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.