NPIMap

Organization Active NPI

Lisel-Anne Balk, D.M.D., LLC

  • Dentist
  • Brighton, MA
National Provider Identifier
1487197968
Registry record updated Jan 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1857120 Issued in MA
Legal business name
LISEL-ANNE BALK, D.M.D., LLC
Practice address
5 South St
Unit 3
Brighton, MA 02135-5111
Phone
(215) 205-5338
NPI assigned
Dec 1, 2016
Last updated
Jan 3, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2017

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

Authorized official

Name
Dr. Lisel-Anne Balk, D.M.D.
Title
Dentist
Phone
(215) 205-5338

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DN1857120 MA Primary

Addresses

Primary practice location

5 South St
Unit 3
Brighton, MA 02135-5111

Mailing address

50 Staniford St
Suite 303
Boston, MA 02114-2517
Phone (617) 523-4555

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1480550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483401600000",
    "number": "1487197968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 STANIFORD ST",
            "address_2": "SUITE 303",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142517",
            "telephone_number": "617-523-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 SOUTH ST",
            "address_2": "UNIT 3",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021355111",
            "telephone_number": "215-205-5338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISEL-ANNE BALK, D.M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-01",
        "last_updated": "2017-01-03",
        "status": "A",
        "authorized_official_last_name": "BALK",
        "authorized_official_first_name": "LISEL-ANNE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "215-205-5338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1857120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2017; 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.