Lesly Y Banos, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

019.034334 Issued in IL

Practice address

7310 Walton St
Rockford, IL 61108-4614

Phone

(815) 395-5555

NPI assigned

Jun 9, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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.

• Il Judge Dental PC

  • General Practice Dentistry
  • Woodstock, IL
  • NPI 1558515791
  NPD (past)

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

{
    "created_epoch": "1686268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1740964998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4421 OLMSTEAD DR",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601921141",
            "telephone_number": "630-229-7528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7310 WALTON ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611084614",
            "telephone_number": "815-395-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANOS",
        "first_name": "LESLY",
        "middle_name": "Y",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-09",
        "last_updated": "2023-06-09",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.034334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• May Marne Jabines Bandilla, PHARMD
• Samantha Ann Baney, APRN
• Donald E Banicki, M.D.
• Brittany L Bankes, NP
• Brittany Bankord
• Errol Christopher Baptist, M.D.
• Sarah Baranski, MMN, RDN
• Mark L. Barba, MD
• Barbara Olson Center of Hope
• Robert L Barclay, M.D.

• Dentist in Rockford, IL
• Providers in Rockford, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; 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.