Alexandre Balaci, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DS028132-L Issued in PA

Practice address

860 Tuck St
Lebanon, PA 17042-7477

Phone

(717) 273-6745

Fax

(717) 273-0009

NPI assigned

Nov 2, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Dec 12, 2016 through Dec 12, 2026

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Annville Dental Group PLLC

  • Dentist
  • Annville, PA
  • NPI 1396474839
  NPD Authorized official
• Lebanon Oral Surgery Group PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Lebanon, PA
  • NPI 1902542863
  NPD Authorized official
• Lehigh Anesthesia Associates, P.C.

  • Anesthesiology Physician
  • Allentown, PA
  • NPI 1508842246
  NPD (past)

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489622400000",
    "number": "1174514830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 TUCK ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427477",
            "telephone_number": "717-273-6745",
            "fax_number": "717-273-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 TUCK ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427477",
            "telephone_number": "717-273-6745",
            "fax_number": "717-273-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALACI",
        "first_name": "ALEXANDRE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2017-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS028132-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "449975",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3905540001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014196710001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "02993801",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "686413",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Bailey, NP-C
• Heather Nicole Bailey, PA-C
• Steven Hadley Bailey, DMD
• Lakeesha Bair Myers
• Neil Baksh, CRNP
• Dawn Baldwin
• Melissa Baldwin, CRNP
• Robert J Balogh Jr., MD
• Rikka Asuncion Banayat, M.D.
• Marlissa Cristina Banta, PHD

• Oral and Maxillofacial Surgery (Dentist) in Lebanon, PA
• Providers in Lebanon, PA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.