Individual provider Active NPI

Denise Banda, D.D.S.

  • Student in an Organized Health Care Education/Training Program
  • Iowa City, IA
National Provider Identifier
1770033698
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
RES-30680 Issued in IA
Practice address
801 Newton Rd
Iowa City, IA 52242-1001
Phone
(319) 335-7440
Fax
(319) 335-7451
NPI assigned
Oct 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 100823 CA
Student in an Organized Health Care Education/Training Program 390200000X RES-30680 IA Primary

Addresses

Primary practice location

801 Newton Rd
Iowa City, IA 52242-1001

Mailing address

322 Dental Science BLDG S
Iowa City, IA 52242-1001
Phone (319) 335-7440

Other practice location 1

4531 Philadelphia St Ste B107
Chino, CA 91710-2249
Phone (310) 350-6199

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

LicenseStateTypeSpecialty
RES-30680IAMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1770033698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 DENTAL SCIENCE BLDG S",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421001",
            "telephone_number": "319-335-7440",
            "fax_number": "319-335-7451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 NEWTON RD",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421001",
            "telephone_number": "319-335-7440",
            "fax_number": "319-335-7451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4531 Philadelphia St Ste B107",
            "address_purpose": "LOCATION",
            "city": "Chino",
            "state": "CA",
            "postal_code": "917102249",
            "country_code": "US",
            "telephone_number": "310-350-6199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANDA",
        "first_name": "DENISE",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-04",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "100823",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IA",
            "license": "RES-30680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.