NPIMap

Organization Active NPI

Annville Dental Group PLLC

  • Dentist
  • Annville, PA
National Provider Identifier
1396474839
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
ANNVILLE DENTAL GROUP PLLC
Practice address
1 Jason Way
Annville, PA 17003
Phone
(717) 867-5088
NPI assigned
Jun 9, 2022
Last updated
Aug 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Authorized official

Name
Alexandre Balaci, DMDNPI 1174514830
Title
Owner
Phone
(717) 273-6745

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

1 Jason Way
Annville, PA 17003

Mailing address

1 Jason Way
Annville, PA 17003
Phone (717) 867-5088

National Provider Directory

National Provider Directory

Locations

1 Jasons Way
Annville, PA 17003
Phone (717) 867-5088

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1654732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1396474839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 JASON WAY",
            "city": "ANNVILLE",
            "state": "PA",
            "postal_code": "17003",
            "telephone_number": "717-867-5088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JASON WAY",
            "city": "ANNVILLE",
            "state": "PA",
            "postal_code": "17003",
            "telephone_number": "717-867-5088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNVILLE DENTAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-09",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "BALACI",
        "authorized_official_first_name": "ALEXANDRE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "717-273-6745",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.