Charles Stewart Bakula, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2021021223 Issued in MO

Practice address

2821 N Ballas Rd Ste 140
Saint Louis, MO 63131-2377

Phone

(314) 432-5544

Fax

(314) 432-7815

NPI assigned

Jul 30, 2021

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Ballasdental

  • Special Hospital
  • Saint Louis, MO
  • NPI 1881059673
  NPD (past)

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

{
    "created_epoch": "1627603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1780357160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2821 N BALLAS RD STE 140",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312377",
            "telephone_number": "314-432-5544",
            "fax_number": "314-432-7815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 N BALLAS RD STE 140",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312377",
            "telephone_number": "314-432-5544",
            "fax_number": "314-432-7815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKULA",
        "first_name": "CHARLES",
        "middle_name": "STEWART",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-30",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2021021223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Baker
• Corina Bakoylis, APRN
• Aureen Reza Baksh, MD
• Brandon Shalim Baksh, MD
• Rahm Jai Bakshi, DO
• Balasudha Baladhandayutham, BDS, MSD
• Balanced Body Rehab LLC
• Balanced Body Wellness LLC
• Balanced Life Counseling & Consulting
• Balanced Longevity Chiropractic Dba Alignlife of St. Louis Southwest

• Dentist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; 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.