Active NPI
Kurt Bally, D.M.D
- General Practice Dentistry
- Jupiter, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN17659
- Practice address
- 4050 S US Highway 1
Suite 322
Jupiter, FL 33477-1123 - Phone
- (561) 691-6055
- NPI assigned
- Mar 20, 2007
- 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 | DN17659 | FL | Primary |
Addresses
Primary practice location
4050 S US Highway 1
Suite 322
Jupiter, FL 33477-1123
Mailing address
4050 S US Highway 1 Ste 322
Jupiter, FL 33477-1123
Phone (561) 691-6055
Other practice location 1
2280 N Congress Ave
Boynton Beach, FL 33426-8604
Phone (561) 732-2400
Other practice location 2
13860 Wellington Trce Ste 14
Wellington, FL 33414-8590
Phone (561) 791-4440
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN17659 | FL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kurt O Bally DMD PA | General Practice | Current | Accepting new patients |
| Modern Dental Smiles of Wellington PA | General Practice | Current | Accepting new patients |
| Modern Dental Smiles PA | General Practice | Current | Accepting new patients |
Locations
2280 N Congress Ave
Boynton Beach, FL 33426
Phone (561) 375-8911
4050 S US Highway 1
Ste 322
Jupiter, FL 33477
Phone (561) 691-6055
13860 Wellington Trce
Ste 14
Wellington, FL 33414
Phone (561) 791-4440
Networks
- Freedom Health HMO Network
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 and National Provider Directory roles.
-
- General Practice Dentistry
- Jupiter, FL
- NPI 1841148475
-
- General Practice Dentistry
- Wellington, FL
- NPI 1922956572
-
- General Practice Dentistry
- Boynton Beach, FL
- NPI 1902754559
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771718400000",
"number": "1497870034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4050 S US HIGHWAY 1 STE 322",
"city": "JUPITER",
"state": "FL",
"postal_code": "334771123",
"telephone_number": "561-691-6055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4050 S US HIGHWAY 1",
"address_2": "SUITE 322",
"city": "JUPITER",
"state": "FL",
"postal_code": "334771123",
"telephone_number": "561-691-6055"
}
],
"practiceLocations": [
{
"address_1": "2280 N Congress Ave",
"address_purpose": "LOCATION",
"city": "Boynton Beach",
"state": "FL",
"postal_code": "334268604",
"country_code": "US",
"telephone_number": "561-732-2400",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "13860 Wellington Trce Ste 14",
"address_purpose": "LOCATION",
"city": "Wellington",
"state": "FL",
"postal_code": "334148590",
"country_code": "US",
"telephone_number": "561-791-4440",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BALLY",
"first_name": "KURT",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-20",
"last_updated": "2026-02-22",
"certification_date": "2026-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN17659",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jupiter, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.