John George Ballouz, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901602663 Issued in MI

Practice address

2700 Martin Luther King Jr Blvd
Detroit, MI 48208-2576

Phone

(313) 494-6873

Fax

(313) 494-6834

NPI assigned

May 20, 2025

Sex

Male

Sole proprietor

Yes

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 MI

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": "1747699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783728000000",
    "number": "1609668128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 MARTIN LUTHER KING JR BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482082576",
            "telephone_number": "313-494-6873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 MARTIN LUTHER KING JR BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482082576",
            "telephone_number": "313-494-6873",
            "fax_number": "313-494-6834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLOUZ",
        "first_name": "JOHN",
        "middle_name": "GEORGE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-20",
        "last_updated": "2026-07-11",
        "certification_date": "2026-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901602663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pearline Ballard, SOCIAL WORKER
• Ronald Ballard, PA
• Takara Joelle Ballard
• Traci Denise Ballard, MA, MPA, LLPC
• William David Ballew
• Antonia Balmaceda, LLMSW
• Richard Balon, MD
• Nancy Marie Balowski
• Robert William Balsiger, DO
• Lydia L. Baltarowich, M.D.

• Dentist in Detroit, MI
• Providers in Detroit, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2026; 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.