Individual provider Active NPI

William J. Ballard III, DDS

  • Dentist
  • Marquette, MI
National Provider Identifier
1053747527
Registry record updated Sep 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901020937 Issued in MI
Practice address
3135 Wright St
Marquette, MI 49855-9615
Phone
(906) 226-8186
Fax
(906) 226-2497
NPI assigned
Sep 17, 2013
Last updated
Sep 17, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901020937 MI Primary

Addresses

Primary practice location

3135 Wright St
Marquette, MI 49855-9615

Mailing address

3135 Wright St
Marquette, MI 49855-9615
Phone (906) 226-8186

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160308001667 MI Order and Referring Only - DentistPractitioner - Dentist 9436455037

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wright Street Dental, PC CurrentSince Aug 28, 2022 Accepting new patients

Locations

3135 Wright St
Marquette, MI 49855
Phone (906) 226-8186

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.

NPI Registry JSON

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379376000000",
    "number": "1053747527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3135 WRIGHT ST",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498559615",
            "telephone_number": "906-226-8186",
            "fax_number": "906-226-2497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3135 WRIGHT ST",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498559615",
            "telephone_number": "906-226-8186",
            "fax_number": "906-226-2497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "WILLIAM",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-17",
        "last_updated": "2013-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

Verify at the official NPI Registry.