Andre Lamar Ballard, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN014841 Issued in GA

Practice address

885 Dawsonville Hwy Ste 1130
Gainesville, GA 30501-2641

Phone

(678) 696-8878

Fax

(678) 696-8879

NPI assigned

Jul 1, 2013

Last updated

Mar 20, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in GA

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

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

{
    "created_epoch": "1372636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1477993756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "885 DAWSONVILLE HWY STE 1130",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012641",
            "telephone_number": "678-696-8878",
            "fax_number": "678-696-8879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 DAWSONVILLE HWY STE 1130",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012641",
            "telephone_number": "678-696-8878",
            "fax_number": "678-696-8879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "ANDRE",
        "middle_name": "LAMAR",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-01",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN014841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norman D Baker Jr., D.O.
• Luke Michele Balding, M.D.
• Tonia A Bales, CRNA
• Zachary Ryan Balest, M.D.
• Preston Ball, MD
• Robert Jay Balotin, M.D.
• Theresa Bamidele, FNP-C
• Lalitha Bandi, M.D.
• Salankara Bandyopadhyay
• Laura J Banner, NP

• Pediatric Dentistry in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Pediatric Dentistry in Georgia

• 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.
• 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.