Randall E Ballweg, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5002051-015 Issued in WI

Practice address

1250 Prairie St
Prairie Du Sac, WI 53578-2041

Phone

(608) 643-8505

Fax

(608) 643-8097

NPI assigned

Jan 11, 2006

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 WI

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

State licenses

Practice roles

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.

• Village Family Dental Assocs.

  • General Practice Dentistry
  • Prairie Du Sac, WI
  • NPI 1407831209

  General Practice

  NPD (past)

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1609855303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 PRAIRIE ST",
            "city": "PRAIRIE DU SAC",
            "state": "WI",
            "postal_code": "535782041",
            "telephone_number": "608-643-8505",
            "fax_number": "608-643-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 PRAIRIE ST",
            "city": "PRAIRIE DU SAC",
            "state": "WI",
            "postal_code": "535782041",
            "telephone_number": "608-643-8505",
            "fax_number": "608-643-8097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLWEG",
        "first_name": "RANDALL",
        "middle_name": "E",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5002051-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Badger EMS Inc
• Ballweg Family Pharmacy Inc
• Ballweg Family Pharmacy Inc
• Caleb J Ballweg, PHARM.D
• Dennis John Ballweg, R.PH.
• Teresa Denise Bare-Inman
• Kristine A Bathke, MD
• Shana Becker-Lindow
• Nicole Carin Been, P.T.
• Laura Elizabeth Bixby, APNP

• All providers in Prairie Du Sac, WI
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.