Alexandria Marie Balich, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

00203121 Issued in CO

Practice address

1636 16TH St
Boulder, CO 80302-6356

Phone

(720) 546-3575

NPI assigned

Jul 14, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Boulder Smiles

  • Dental Clinic/Center
  • Boulder, CO
  • NPI 1891423208
  NPD Authorized official

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1043627821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1636 16TH ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803026356",
            "telephone_number": "720-546-3575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1636 16TH ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803026356",
            "telephone_number": "720-546-3575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1312 W MADISON ST APT 3A",
            "address_purpose": "LOCATION",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60607",
            "country_code": "US",
            "telephone_number": "815-302-0370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALICH",
        "first_name": "ALEXANDRIA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-14",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "00203121",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019029829",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelty Rose Balcerzak
• Sara Baldocchi, MOT, OTR/L
• Lisa M Balduf, MD
• Hans Baldursson
• Marykathryn Margaret Baldwin
• Kevin Matthew Ball-Duane, PSYD
• Lavinia E. Ball-Marian, M.A.
• Deena Ball
• Winter Ball, PT, DPT
• Sherrie Lynn Ballantine-Talmadge, D.O.

• General Practice Dentistry in Boulder, CO
• Providers in Boulder, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; 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.