Ballwin Family Smiles, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

BALLWIN FAMILY SMILES, PLLC

Practice address

15208 Manchester Rd
Ballwin, MO 63011-4601

Phone

(918) 998-0996

NPI assigned

Mar 20, 2023

Last updated

Mar 20, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Creed Cardon

Title

Owner

Phone

(918) 998-0996

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679270400000",
    "number": "1356043814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 RIVERWALK TER STE 250",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740375619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15208 MANCHESTER RD",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630114601",
            "telephone_number": "918-998-0996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALLWIN FAMILY SMILES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-20",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A",
        "authorized_official_last_name": "CARDON",
        "authorized_official_first_name": "CREED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-998-0996"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cari R Bailey Smith, RD
• Jay Scott Baker, M.D.
• Rebecca J Baker
• Cynthia Renee Ballentine, OTR
• Ballwin Chiropractic Center, PC
• Ballwin Health Care LLC (Ballwin Ridge Health & Rehabilitation)
• Ballwin Orthopedic Group, LLC
• Alan James Banaszynski, DC
• Marissa Paulette Barbeau, PLPC
• Derrick Bark, DC, ATC

• General Practice Dentistry in Ballwin, MO
• Providers in Ballwin, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; 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.