P MICHAEL BANASIK (NPI# 1932103900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932103900 |
| Entity Type | Individual |
| Full Name | P MICHAEL BANASIK |
| Credential | DDS |
| Practice Address |
1836 South Ave La Crosse WI 54601-5429 |
| Practice Telephone | 6087827300 |
| Practice Fax Number | 6087754467 |
| Mailing Telephone | 6087827300 |
| Mailing Fax Number | 6087754467 |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
5000273 | WI | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 33663300 | 05 |
| Street Address |
1836 SOUTH AVE |
| City | LA CROSSE |
| State | WI |
| Zip Code | 54601-5429 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952304834 | Susan G Maclellan-tobert | Pediatrics | 1836 South Ave, La Crosse, WI 54601-5429 | 2005-05-24 |
| 1861099590 | Ellen Compton | Dietitian, Registered | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-10-06 |
| 1699382630 | Jedd Sebion | Pharmacist | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-09-24 |
| 1104436351 | Taryn Jean Simon | Speech-Language Pathologist | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-08-03 |
| 1497376438 | Eva Igler | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-30 |
| 1568083608 | Benjamin Haase Thompson | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-29 |
| 1316568736 | Eric Bobel | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-27 |
| 1134749708 | Kristin Danielle Heslep | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-23 |
| 1982224598 | Rebecca Stanek | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-23 |
| 1609496595 | Marie Gilberte Cineus | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891324265 | Meagan Mcrae | Student in an Organized Health Care Education/Training Program | 1725 State St., 4051 Health Science Center, La Crosse, WI 54601 | 2020-04-07 |
| 1255969671 | Erin Dingman | Student in an Organized Health Care Education/Training Program | 1751 State Street, 4051 Health Science Center, La Crosse, WI 54601 | 2020-03-31 |
| 1619505047 | Nicole Kay Lynch | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State St, La Crosse, WI 54601 | 2020-03-31 |
| 1174151757 | Jenna Sells | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1740818301 | Katie Irene Tahtinen | Student in an Organized Health Care Education/Training Program | Uwl- 4051 Health Science Center, 1725 State St., La Crosse, WI 54601 | 2020-03-30 |
| 1932737517 | Margaret May Grimm | Student in an Organized Health Care Education/Training Program | Univesity of Wisconsin-la Crosse, 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1831727312 | Matthew Timothy Axler | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1093340473 | Denise Stinson | Technician | 1311 Badger St, Apt 505, La Crosse, WI 54601 | 2020-03-06 |
| 1922632397 | Ibrahim Ahsan | Pharmacist | 1105 Wi-16, La Crosse, WI 54601 | 2020-02-25 |
| 1750913356 | Liza R Collins | Massage Therapist | 1415 State Wi 16, La Crosse, WI 54601 | 2020-02-11 |
| Find all providers in zip 54601 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447254305 | Timothy Brekke Durtsche | Dentist | 615 10th St S, La Crosse, WI 54601-4768 | 2005-06-09 |
| 1699035576 | Lauren Marie Castro | Dentist | 1836 South Ave, La Crosse, WI 54601-5429 | 2012-05-24 |
| 1144587551 | Mark James Erickson | Dentist | 1836 South Ave, La Crosse, WI 54601 | 2012-04-23 |
| 1932362092 | Andy Kabele | Dentist | 1836 South Ave, La Crosse, WI 54601-5429 | 2008-07-08 |
| 1053582916 | Deepa T. Sathiah | Dentist | 1836 South Ave, La Crosse, WI 54601-5429 | 2008-03-19 |
| 1932151685 | Drs. Anderson & Durtsche, Ltd. | Dentist | 615 10th St S, La Crosse, WI 54601-4768 | 2006-05-17 |
| 1639158660 | Martin John Koop | Dentist | 1836 South Ave, La Crosse, WI 54601-5429 | 2006-01-10 |
| 1205814407 | Thomas Stuart Mackenzie | Dentist | 1836 South Ave, La Crosse, WI 54601-5429 | 2006-01-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720569783 | Greater Milwaukee Oral Surgery, L.L.C. | Dentist | 4811 S 76th St Ste 304, Greenfield, WI 53220-4350 | 2018-08-27 |
| 1124516893 | Baycare Clinic, LLP | Dentist | 636 N 12th Ave, Sturgeon Bay, WI 54235-1249 | 2018-04-27 |
| 1477065787 | Central Wisconsin Oral and Facial Surgery, LLC | Dentist | 438 Edison St, Antigo, WI 54409-1845 | 2017-10-26 |
| 1497266910 | Donald Ervin Linneman | Dentist | Center 4820 N Sherman Road, Winnebago Correction Center, Drug Abuse Correctional, Winnebago, WI 54985-0036 | 2017-10-24 |
| 1063869485 | Tyler Kalmuck | Dentist | 3637 Wilgus Ave, Sheboygan, WI 53081-3050 | 2016-05-16 |
| 1952717753 | Judson Charles Smith | Dentist | 2323 N Mayfair Rd Ste 102, Milwaukee, WI 53226 | 2014-07-01 |
| 1073930459 | Paul Pamula | Dentist | 1925 S Green Bay Rd, Mount Pleasant, WI 53406-4654 | 2014-03-24 |
| 1326473927 | Lake Geneva Dental Care, LLC | Dentist | 1454 E Huebbe Pkwy, Beloit, WI 53511-1714 | 2013-09-13 |
| 1093154601 | Matthew D Reiland | Dentist | 2921 Landmark Pl Ste 100, Madison, WI 53713-4248 | 2013-06-17 |
| 1922364363 | Ell Louis Lee | Dentist | 2361 Lost Dauphin Rd, De Pere, WI 54115-9165 | 2012-04-10 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on P MICHAEL BANASIK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.