Individual provider Active NPI

Richard Joseph Ballas, D.D.S.

  • General Practice Dentistry
  • Westlake, OH
National Provider Identifier
1205989357
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30013031 Issued in OH
Practice address
24700 Center Ridge Rd
Westlake, OH 44145-5636
Phone
(440) 871-0550
Fax
(440) 871-0550
NPI assigned
Jan 20, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30013031 OH Primary

Addresses

Primary practice location

24700 Center Ridge Rd
Westlake, OH 44145-5636

Mailing address

24700 Center Ridge Rd
Westlake, OH 44145-5636
Phone (440) 871-0550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20150518001959 OH Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5698095453

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30013031OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1169251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205989357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24700 CENTER RIDGE RD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455636",
            "telephone_number": "440-871-0550",
            "fax_number": "440-871-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24700 CENTER RIDGE RD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455636",
            "telephone_number": "440-871-0550",
            "fax_number": "440-871-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLAS",
        "first_name": "RICHARD",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30013031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake, OH

Sources for this page

Verify at the official NPI Registry.