Active NPI
David Allen Banach, DDS
- Endodontics
- Jamestown, NY
National Provider Identifier
1760529762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 039007
- Practice address
- 205 E 6TH St
Jamestown, NY 14701-5327 - Phone
- (716) 661-3021
- Fax
- (716) 661-3020
- NPI assigned
- Jan 31, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 039007 | NY | Primary |
Addresses
Primary practice location
205 E 6TH St
Jamestown, NY 14701-5327
Mailing address
446 Lake Shore Dr W
Dunkirk, NY 14048-1478
Phone (716) 363-0301
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 039007 | NY | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760529762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "446 LAKE SHORE DR W",
"city": "DUNKIRK",
"state": "NY",
"postal_code": "140481478",
"telephone_number": "716-363-0301",
"fax_number": "716-363-1363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 E 6TH ST",
"city": "JAMESTOWN",
"state": "NY",
"postal_code": "147015327",
"telephone_number": "716-661-3021",
"fax_number": "716-661-3020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANACH",
"first_name": "DAVID",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "NY",
"license": "039007",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamestown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.