Individual provider Active NPI

Anna Ball, DMD

  • General Practice Dentistry
  • Lake Oswego, OR
National Provider Identifier
1073497178
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D12246 Issued in OR
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

Updated by the provider on Aug 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250912000215 OR Order and Referring Only - DentistPractitioner - 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

Verify at the official NPI Registry.