Charles Keith Balisha, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

27584 Issued in CA

Practice address

215 N Thor #a
Turlock, CA 95380

Phone

(209) 667-9264

Fax

(209) 667-9305

NPI assigned

Nov 28, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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)

Enrolled

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780751727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 N THOR #A",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "95380",
            "telephone_number": "209-667-9264",
            "fax_number": "209-667-9305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N THOR #A",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "95380",
            "telephone_number": "209-667-9264",
            "fax_number": "209-667-9305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALISHA",
        "first_name": "CHARLES",
        "middle_name": "KEITH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "27584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harold Edward Baker IX, PA
• Inderpal K Bal, MD
• Gustavo Balderas
• Terri Balderas
• Martha Beatriz Baldwin, LCSW
• Myleen Basa Baluyot, MD
• Leanne Banda
• Nicole Marie Baragno
• Lisbet Barajas
• Ruby Barajas

• General Practice Dentistry in Turlock, CA
• Providers in Turlock, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.