Patrick J Bannon, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19A14515 Issued in IL

Practice address

432 W 75TH Street
Downers Grove, IL 60516

Phone

(630) 971-0751

Fax

(630) 971-0796

NPI assigned

Sep 17, 2006

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

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.

• Martha P Jaimes Dentistry Professional Corp.

  • Dental Clinic/Center
  • Downers Grove, IL
  • NPI 1316734577
  NPD (past)
• Martha P Jaimes Dentistry Professional Corp.

  • Dental Clinic/Center
  • Downers Grove, IL
  • NPI 1922719467
  NPD (past)

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881791507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 W 75TH STREET",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "60516",
            "telephone_number": "630-971-0751",
            "fax_number": "630-971-0796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 W 75TH STREET",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "60516",
            "telephone_number": "630-971-0751",
            "fax_number": "630-971-0796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNON",
        "first_name": "PATRICK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19A14515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith F Ball, MS,CCC,SLP
• Alexis Baltrusch
• Brooklyn Bane
• Michelle Bankhead
• Takiyah Banks, RN
• Joanna Giacinta Bansfield, FNP-BC
• Shamita V Bansore, MD
• Sara E. Banuelos, D.D.S
• Justina Baranauskaite, ND, LAC
• Barbara E. B. Myers, D.M.D., P.C.

• General Practice Dentistry in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• General Practice Dentistry in Illinois

• 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.

Verify at the official NPI Registry.