Individual provider Active NPI

Cecilia A Balbuena, DDS

  • Dentist
  • Allentown, PA
National Provider Identifier
1053506576
Registry record updated Sep 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS035060 Issued in PA
Practice address
845 W Tilghman Street
Allentown, PA 18102-2301
Phone
(610) 433-4533
Fax
(610) 433-4543
NPI assigned
Sep 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS035060 PA Primary

Addresses

Primary practice location

845 W Tilghman Street
Allentown, PA 18102-2301

Mailing address

845 W Tilghman Street
Allentown, PA 18102-2301
Phone (610) 433-4533

Other identifiers 1

IdentifierTypeStateIssuer
01940331MedicaidPA

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

LicenseStateTypeSpecialty
DS035060PAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189123200000",
    "number": "1053506576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 W TILGHMAN STREET",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181022301",
            "telephone_number": "610-433-4533",
            "fax_number": "610-433-4543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 W TILGHMAN STREET",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181022301",
            "telephone_number": "610-433-4533",
            "fax_number": "610-433-4543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALBUENA",
        "first_name": "CECILIA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-07",
        "last_updated": "2007-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS035060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01940331",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; 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.