Eriselda Bano, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN1859615 Issued in MA

Practice address

1208B VFW Pkwy Ste 307
West Roxbury, MA 02132-4350

Phone

(617) 325-4100

NPI assigned

Dec 14, 2022

Sex

Female

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

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

{
    "created_epoch": "1670976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1952013518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 CASS ST APT 7",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021324820",
            "telephone_number": "617-637-5696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208B VFW PKWY STE 307",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021324350",
            "telephone_number": "617-325-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANO",
        "first_name": "ERISELDA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-14",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1859615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Awakening Excellence LLC
• Jennifer Nequia Aying, N.P.
• Melanie May Bachteler, LAT, ATC
• Eugene Adivoso Bacorro, M.D.
• Georgina Ball, LMHC
• Neil Adrian Andogan Banoey
• Laura Banty, DMD
• Rowan Baptiste Jr.
• Julie A. Barboza, NP
• Yesha Patel Barker, M.D.

• General Practice Dentistry in West Roxbury, MA
• Providers in West Roxbury, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; 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.