Provider Demographics
NPI:1649392861
Name:BANKS, ERNIE RICARDO (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERNIE
Middle Name:RICARDO
Last Name:BANKS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6067 OXON HILL RD
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-3124
Mailing Address - Country:US
Mailing Address - Phone:301-839-4965
Mailing Address - Fax:301-839-4966
Practice Address - Street 1:6067 OXON HILL RD
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3124
Practice Address - Country:US
Practice Address - Phone:301-839-4965
Practice Address - Fax:301-839-4966
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD97081223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics