Provider Demographics
NPI:1952771206
Name:BANT, ANKITA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANKITA
Middle Name:
Last Name:BANT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1442 E ZION WAY
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-5195
Mailing Address - Country:US
Mailing Address - Phone:615-983-0903
Mailing Address - Fax:
Practice Address - Street 1:10 S KYRENE RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-4524
Practice Address - Country:US
Practice Address - Phone:480-292-7725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10160122300000X
AZD0093111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist