Bana Ball DMD LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

BANA BALL DMD LLC

Doing business as

Shady Grove Pediatric Dentistry

Practice address

15245 Shady Grove Rd Ste 260
Rockville, MD 20850-3222

Phone

(240) 848-7074

Fax

(240) 848-7075

NPI assigned

Oct 30, 2019

Last updated

Oct 30, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Banafsheh M Ball, DMDNPI 1720394794

Title

Pediatric Dentist; Owner

Phone

(240) 848-7074

Specialties & licenses 1

Addresses

Other names 1

• Shady Grove Pediatric Dentistry Doing business as

Locations

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.

• Banafsheh M Ball, D.M.D.

  • Pediatric Dentistry
  • Rockville, MD
  • NPI 1720394794
  NPD Authorized official

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

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572393600000",
    "number": "1548804867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15609 WAPELLO WAY",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208552642",
            "telephone_number": "423-737-8208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15245 SHADY GROVE RD STE 260",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503222",
            "telephone_number": "240-848-7074",
            "fax_number": "240-848-7075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANA BALL DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-30",
        "last_updated": "2019-10-30",
        "status": "A",
        "authorized_official_last_name": "BALL",
        "authorized_official_first_name": "BANAFSHEH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST; OWNER",
        "authorized_official_telephone_number": "240-848-7074",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shady Grove Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Baltierra Castro
• Kelina Baltimore
• Sarah Yasmine Bamba
• Adrienne Bambach, PH.D., D(ABMM)
• Olayinka Bamife
• Kristin Bandi, BCBA, LBA
• Destiny Bandy, OTR/L
• Keva Bandy
• Stacy Jung Bang, M.D.
• Amina Bangura

• Pediatric Dentistry in Rockville, MD
• Providers in Rockville, MD by specialty
• Pediatric Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; 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.