Jay E Balasz, DDS
Individual provider Active NPI General Practice Dentistry · Charlevoix, MI
NPI 1063521045 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1063521045
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 2901014379 (MI)
- Practice address
- 707 Bridge St
Charlevoix, MI 49720-1419 - Phone
- (231) 547-2377
- Fax
- (231) 547-5372
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150605000202 | MI | Order and Referring Only - Oral Surgery |
9133440951 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2901014379 | MI | Yes |
Addresses
Primary practice location
707 Bridge St
Charlevoix, MI 49720-1419
Mailing address
707 Bridge St
Charlevoix, MI 49720-1419
Phone (231) 547-2377
Other providers in Charlevoix, MI
- Amanda Evans Nutrition Consulting, LLC
- Martha Margaret Anderson
- Jennifer Armstrong
- Kelsey Arnold
- Laurie Ann Azolas
- Matthew David Batdorff
- Tiffany Ann Baxter
- Bay Area Substance Education Services
- Bay Street Orthopaedics PLLC
- Beacon Dental Center
All providers in Charlevoix, MI · General Practice Dentistry in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.