Elizabeth Balis, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DI19807 Issued in NJ

Practice address

474 Hurffville Crosskeys Rd
Atrium 1 Suite a
Sewell, NJ 08080-2321

Phone

(856) 582-1000

Fax

(856) 589-1093

NPI assigned

Mar 6, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jun 7, 2016 through Jun 7, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Washington TWP Dental Assoc, P.a.

  • Dentist
  • Sewell, NJ
  • NPI 1730305640
  NPD (past)

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073643797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 OAK RIDGE LN",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802442",
            "telephone_number": "856-582-1000",
            "fax_number": "856-589-1093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "474 HURFFVILLE CROSSKEYS RD",
            "address_2": "ATRIUM 1 SUITE A",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802321",
            "telephone_number": "856-582-1000",
            "fax_number": "856-589-1093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALIS",
        "first_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI19807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Marie Baer, BCBA
• Surendra K Bagaria, MD
• Stasia M. Bahring, PT, DPT
• James William Bailey, D.O.
• Jody Williams Baker, RN, MSN, APN, C.
• John Ballinger
• Louis H Balsama, D.O.
• Nancy Baltzell-Musuras, AUD
• Bancroft a New Jersey Nonprofit Corporation
• Marla Deneen Banks, ATC MED

• Dentist in Sewell, NJ
• Providers in Sewell, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.