Frederick Vernon Ballard Jr., D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

22DI02447500 Issued in NJ

Practice address

501 White Horse Pike
West Collingswood, NJ 08107-1729

Phone

(856) 854-1509

NPI assigned

Dec 1, 2008

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kool Koala Pediatric and Adolescent Dentistry

  • Pediatric Dentistry
  • Collingswood, NJ
  • NPI 1295112043
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481068800000",
    "number": "1003061276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 WHITE HORSE PIKE",
            "city": "WEST COLLINGSWOOD",
            "state": "NJ",
            "postal_code": "081071729",
            "telephone_number": "856-854-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 WHITE HORSE PIKE",
            "city": "WEST COLLINGSWOOD",
            "state": "NJ",
            "postal_code": "081071729",
            "telephone_number": "856-854-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "FREDERICK",
        "middle_name": "VERNON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-01",
        "last_updated": "2016-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22DI02447500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa S Chase, DO
• Collingswood Dental Assoc PA
• Javier Victor Duran, DMD
• Hartford Universal Inc
• Roger Hugh Sheinkin, D.D.S.

• Pediatric Dentistry in West Collingswood, NJ
• Providers in West Collingswood, NJ by specialty
• Pediatric Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.