Balaji Kolasani, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12014415A Issued in IN

Practice address

8180 Pendleton Pike
Lawrence, IN 46226-4015

Phone

(317) 426-1562

NPI assigned

May 28, 2024

Sex

Male

Sole proprietor

No

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.

• Primecare Dental LLC

  • Dentist
  • Indianapolis, IN
  • NPI 1356002323
  NPD

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: balaji.kolasani.p1@direct.meridianhs.nextgenshare.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 28, 2024.

{
    "created_epoch": "1716854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1619717618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8180 PENDLETON PIKE",
            "city": "LAWRENCE",
            "state": "IN",
            "postal_code": "462264015",
            "telephone_number": "317-426-1562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8180 PENDLETON PIKE",
            "city": "LAWRENCE",
            "state": "IN",
            "postal_code": "462264015",
            "telephone_number": "317-426-1562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLASANI",
        "first_name": "BALAJI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-28",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12014415A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Lawrence, IN
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; 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.