Alexander Dmitry Banketov, DDS
NPI 1124857164ActiveIndividual· Dentist· Omaha, NE
Dentist (DDS) in Omaha, Nebraska, licensed in NE and NC, with an NPI issued in July 2024. Enrolled in Medicare as order and referring only - dentist.
Overview
| NPI | 1124857164 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DDS |
| Sole proprietor | No |
| NPI issued | Jul 29, 2024 |
| Last updated in NPPES | Jan 15, 2025 |
| Certified by provider | Jan 15, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X | 8056 | NE |
| Dentist | 122300000X | 13921 | NC |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Order and Referring Only - Dentist (NE) |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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