Active NPI
James Keith Ballard Jr., DMD
- General Practice Dentistry
- Brookhaven, MS
National Provider Identifier
1003309311
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4005-18
- Practice address
- 706 Brookway Blvd
Brookhaven, MS 39601-2640 - Phone
- (601) 823-3200
- NPI assigned
- Jun 11, 2018
- Last updated
- Jun 11, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4005-18 | MS | Primary |
Addresses
Primary practice location
706 Brookway Blvd
Brookhaven, MS 39601-2640
Mailing address
706 Brookway Blvd
Brookhaven, MS 39601-2640
Phone (601) 823-3200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4005-18 | MS | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| W. Don Doty, D.M.D., General Dentistry, a Professional Corp | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Brookway Dental
- General Practice Dentistry
- Brookhaven, MS
- NPI 1265518906
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528675200000",
"number": "1003309311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "706 BROOKWAY BLVD",
"city": "BROOKHAVEN",
"state": "MS",
"postal_code": "396012640",
"telephone_number": "601-823-3200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "706 BROOKWAY BLVD",
"city": "BROOKHAVEN",
"state": "MS",
"postal_code": "396012640",
"telephone_number": "601-823-3200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALLARD",
"first_name": "JAMES",
"middle_name": "KEITH",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-11",
"last_updated": "2018-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MS",
"license": "4005-18",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookhaven, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.