Active NPI
Ryan Timothy Baller, D.D.S.
- General Practice Dentistry
- Sioux City, IA
National Provider Identifier
1356578256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 08626
- Practice address
- 4100 Morningside Ave
Sioux City, IA 51106-2974 - Phone
- (712) 274-2038
- NPI assigned
- Jun 18, 2009
- Last updated
- Feb 14, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 08626 | IA | Primary |
Addresses
Primary practice location
4100 Morningside Ave
Sioux City, IA 51106-2974
Mailing address
1021 Nebraska St
P.O. Box 5410
Sioux City, IA 51102
Phone (712) 202-1006
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160302000643 | IA | Order and Referring Only - Dentist | 4880999770 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Restoreu LLC | General Practice | Current | Accepting new patients |
| Baller and Wineland LLC | Current | Accepting new patients | |
| Douglas a. Wheelock, DDS, PC | General Practice | Past | Accepting new patients |
Locations
4100 Morningside Ave
Sioux City, IA 51106
Phone (712) 274-2038
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba James E. Buttermore, DDS, PC
- General Practice Dentistry
- South Sioux City, NE
- NPI 1467155333
-
dba Wheelock and Bursick Dentistry
- General Practice Dentistry
- Sioux City, IA
- NPI 1801225578
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676332800000",
"number": "1356578256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1021 NEBRASKA ST",
"address_2": "P.O. BOX 5410",
"city": "SIOUX CITY",
"state": "IA",
"postal_code": "51102",
"telephone_number": "712-202-1006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 MORNINGSIDE AVE",
"city": "SIOUX CITY",
"state": "IA",
"postal_code": "511062974",
"telephone_number": "712-274-2038"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALLER",
"first_name": "RYAN",
"middle_name": "TIMOTHY",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-18",
"last_updated": "2023-02-14",
"certification_date": "2023-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IA",
"license": "08626",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sioux City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; 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.