Andreas Juerg Baltzly, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

30.025508 Issued in OH

Practice address

8562 Navarre Rd SW
Massillon, OH 44646-8814

Phone

(330) 879-0121

NPI assigned

Jul 27, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• MDC Oshkosh II, L.L.C.

  • Dental Clinic/Center
  • Oshkosh, WI
  • NPI 1841845674
  NPD
• Modern Dental Center Oshkosh LLC

  • Dentist
  • Oshkosh, WI
  • NPI 1538815733
  NPD
• Lawrence J Salata DDS Inc

  • Dental Clinic/Center
  • Massillon, OH
  • NPI 1891960449
  NPD (past)

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

{
    "created_epoch": "1532649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1275010654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8562 NAVARRE RD SW",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446468814",
            "telephone_number": "330-879-0121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8562 NAVARRE RD SW",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446468814",
            "telephone_number": "330-879-0121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1795 W Pointe Dr",
            "address_purpose": "LOCATION",
            "city": "Oshkosh",
            "state": "WI",
            "postal_code": "54902",
            "country_code": "US",
            "telephone_number": "920-235-6453",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALTZLY",
        "first_name": "ANDREAS",
        "middle_name": "JUERG",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-27",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.025508",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.025508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey D. Baker, CDCA
• Katelyn Joy Baker
• Christa Balder, APRN
• Mark Charles Ballard, LPCC
• Baltzly West Incorporated
• Gawaine J Banks, PH.D.
• Angela Marie Barber, O.D.
• Renette Bardin, CRNA
• Patricia Louise Bardnell, CDCA
• McLaren Ashleigh Barone

• Dentist in Massillon, OH
• Providers in Massillon, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.