Mark Balonek, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

041559 Issued in NY

Practice address

513 Beahan Rd
Rochester, NY 14624-3403

Phone

(585) 426-3050

NPI assigned

Jan 11, 2007

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 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326198565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 BEAHAN RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146243403",
            "telephone_number": "585-426-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 BEAHAN RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146243403",
            "telephone_number": "585-426-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALONEK",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "041559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE NUMBER",
            "identifier": "041559",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Nicole Ballou, OTR/L
• Mallory Anne Balmer-Swain, DO
• Ari Balofsky, M.D.
• Toluwani Loveth Balogun, MD
• Balonek DDS PC
• Deborah Ann Balouris, LCSW
• Brian Balsamo, PA
• Milin Balsara
• Amanda Elyse Balseca, LAC
• Dawn Marie Balsis, LMSW

• General Practice Dentistry in Rochester, NY
• Providers in Rochester, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.