Abdulaziz Banasser, BDS

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

License

DRPM1792 Issued in FL

Practice address

1395 Center Dr
Gainesville, FL 32610-3006

Phone

(352) 273-6683

NPI assigned

Oct 23, 2018

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Faculty Associates, Inc

  • Periodontics
  • Gainesville, FL
  • NPI 1275084204
  NPD (past)
• University of Florida

  • Dentist
  • Gainesville, FL
  • NPI 1053726778
  NPD (past)

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

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1730655192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 CENTER DR GAINESVILLE FL 32610-3006",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100001",
            "telephone_number": "352-273-6683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 CENTER DR",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103006",
            "telephone_number": "352-273-6683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANASSER",
        "first_name": "ABDULAZIZ",
        "credential": "BDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-23",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "FL",
            "license": "DRPM1792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA DEPARTMENT OF HEALTH",
            "identifier": "DRPM1792",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caroline Baltrucki, OT
• Katherine Elizabeth Baltzelle
• Marvin R Balza
• Elizabeth Bamiro
• Genevieve Banaag
• Gary Wayne Banfield, D,D,S,
• Grant Patrick Banfill
• Bradley P Bangstad, O.D.
• Lesley Chuc Banh
• Wanda Banhan, PA-C

• Oral and Maxillofacial Pathology Dentistry in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Oral and Maxillofacial Pathology Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2020; 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.