Individual provider Active NPI

Rommel Kaur Bal, DDS

  • Dentist
  • Stockton, CA
National Provider Identifier
1730264219
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
53755 Issued in CA
Practice address
1545 St Marks Plaza
Suite 11
Stockton, CA 95207
Phone
(209) 957-1244
Fax
(209) 957-2591
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 53755 CA Primary

Addresses

Primary practice location

1545 St Marks Plaza
Suite 11
Stockton, CA 95207

Mailing address

1545 St Marks Plaza
Suite 11
Stockton, CA 95207
Phone (209) 957-1244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20150922003216 CA Order and Referring Only - DentistPractitioner - Other (Physician)Practitioner - Dentist 5092022186

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53755CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Rommel K Bal DDS a Dental Corporation CurrentSince Dec 1, 2018 Accepting new patients
Stockton Sleep Center Inc Past Accepting new patients

Locations

1545 Saint Marks Plz
Ste 1
Stockton, CA 95207
Phone (209) 957-1244

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730264219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 ST MARKS PLAZA",
            "address_2": "SUITE 11",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95207",
            "telephone_number": "209-957-1244",
            "fax_number": "209-957-2591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 ST MARKS PLAZA",
            "address_2": "SUITE 11",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95207",
            "telephone_number": "209-957-1244",
            "fax_number": "209-957-2591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAL",
        "first_name": "ROMMEL",
        "middle_name": "KAUR",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "53755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.