Active NPI
Clifton Lee Ball, DDS.
- General Practice Dentistry
- Winston Salem, NC
National Provider Identifier
1073657433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4830
- Practice address
- 2912 Maplewood Avenue
Winston Salem, NC 27103-4010 - Phone
- (336) 765-8940
- Fax
- (336) 765-1473
- NPI assigned
- Feb 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4830 | NC | Primary |
Addresses
Primary practice location
2912 Maplewood Avenue
Winston Salem, NC 27103-4010
Mailing address
2912 Maplewood Avenue
Winston Salem, NC 27103-4010
Phone (336) 765-8940
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4830 | NC | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282521600000",
"number": "1073657433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2912 MAPLEWOOD AVENUE",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271034010",
"telephone_number": "336-765-8940",
"fax_number": "336-765-1473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2912 MAPLEWOOD AVENUE",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271034010",
"telephone_number": "336-765-8940",
"fax_number": "336-765-1473"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALL",
"first_name": "CLIFTON",
"middle_name": "LEE",
"name_prefix": "Mr.",
"credential": "DDS.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-19",
"last_updated": "2010-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "4830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.