Lourdes V. Ballet, DDS
Individual provider Active NPI General Practice Dentistry · Deltona, FL
NPI 1255517850 · NPPES record last updated Jan 14, 2008
Key facts
- NPI
- 1255517850
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DN16520 (FL)
- Practice address
- 1857 Providence Blvd
Deltona, FL 32725-3811 - Phone
- (321) 283-2850
- Fax
- (386) 951-4809
- NPI assigned
- Jan 14, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN16520 | FL | MD | General Practice Dentistry |
Networks
- Freedom Health HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN16520 | FL | Yes |
Addresses
Primary practice location
1857 Providence Blvd
Deltona, FL 32725-3811
Mailing address
1857 Providence Blvd
Deltona, FL 32725-3811
Phone (321) 283-2850
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 421713899 | Other | FL | TAX IDENTIFICATION NUMBER |
Other providers in Deltona, FL
- Rachel Babilla
- Back & I Medical LLC
- Back in Action Chiropractic
- Cassidy Ball
- Ballet Dental Care
- Johnnie Lewis Balous Jr.
- Tyesha Denise Banks
- Taylor Raeanne Barber
- Mitza Barcelo Montes
- Stephanie Bardales
All providers in Deltona, FL · General Practice Dentistry in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.