Active NPI
William Bentley Banister, DDS
- Dentist
- Springdale, AR
National Provider Identifier
1821718222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4734
- Practice address
- 2111 S Old Missouri Rd
Springdale, AR 72764-8718 - Phone
- (479) 340-0005
- NPI assigned
- Aug 29, 2022
- Last updated
- May 22, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4734 | AR | Primary |
| Dentist | 122300000X | 38924 | TX | |
| General Practice Dentistry | 1223G0001X | 38924 | TX |
Addresses
Primary practice location
2111 S Old Missouri Rd
Springdale, AR 72764-8718
Mailing address
1805 Duke Dr
Richardson, TX 75081-3131
Phone (479) 530-1099
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 |
|---|---|---|---|
| 4734 | AR | MD | Dentist |
| 38924 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peppermint Dental | Dentist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716336000000",
"number": "1821718222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1805 DUKE DR",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "750813131",
"telephone_number": "479-530-1099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2111 S OLD MISSOURI RD",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727648718",
"telephone_number": "479-340-0005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANISTER",
"first_name": "WILLIAM",
"middle_name": "BENTLEY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-08-29",
"last_updated": "2024-05-22",
"certification_date": "2024-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AR",
"license": "4734",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "38924",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "38924",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springdale, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.