Active NPI
Anna Ball, DMD
- General Practice Dentistry
- Lake Oswego, OR
National Provider Identifier
1073497178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D12246
- Practice address
- 16679 Boones Ferry Rd Ste 215
Lake Oswego, OR 97035-4368 - Phone
- (503) 636-7601
- Fax
- (503) 636-3749
- NPI assigned
- Aug 1, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D12246 | OR | |
| General Practice Dentistry | 1223G0001X | D12246 | OR | Primary |
Addresses
Primary practice location
16679 Boones Ferry Rd Ste 215
Lake Oswego, OR 97035-4368
Mailing address
16679 Boones Ferry Rd Ste 215
Lake Oswego, OR 97035-4368
Phone (503) 636-7601
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250912000215 | OR | Order and Referring Only - Dentist | 4183127475 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1754006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754006400000",
"number": "1073497178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16679 BOONES FERRY RD STE 215",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970354368",
"telephone_number": "503-636-7601",
"fax_number": "503-636-3749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16679 BOONES FERRY RD STE 215",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970354368",
"telephone_number": "503-636-7601",
"fax_number": "503-636-3749"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALL",
"first_name": "ANNA",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-08-01",
"last_updated": "2025-08-01",
"certification_date": "2025-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OR",
"license": "D12246",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OR",
"license": "D12246",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lake Oswego, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.