Healthcare Provider Details

I. General information

NPI: 1184160517
Provider Name (Legal Business Name): JAMINELLI L BANKS DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2017
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3811 E BELL RD STE 207
PHOENIX AZ
85032-2159
US

IV. Provider business mailing address

20011 N 19TH ST
PHOENIX AZ
85024-1230
US

V. Phone/Fax

Practice location:
  • Phone: 480-863-6044
  • Fax: 602-926-1299
Mailing address:
  • Phone: 480-471-6132
  • Fax: 480-393-1979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPOD-001064
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License NumberPOD-001064
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPOD-001064
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE5697
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberPOD-001064
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: