Individual provider Active NPI

Steven Spenser Balandran, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Spring, TX
National Provider Identifier
1790210292
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
38331 Issued in TX
Practice address
8687 Louetta Rd Ste 100
Spring, TX 77379-6674
Phone
(281) 370-4034
Fax
(281) 374-8251
NPI assigned
Apr 22, 2017
Last updated
Jun 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 38331 TX Primary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 38331 TX

Addresses

Primary practice location

8687 Louetta Rd Ste 100
Spring, TX 77379-6674

Mailing address

4185 Technology Forest Blvd Ste 100
The Woodlands, TX 77381-2004
Phone (713) 486-4052

Other practice location 1

4185 Technology Forest Blvd Ste 100
The Woodlands, TX 77381-2004
Phone (281) 370-4034

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 12, 2023 through Apr 12, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
38331TXMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1492819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1790210292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4185 TECHNOLOGY FOREST BLVD STE 100",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773812004",
            "telephone_number": "713-486-4052",
            "fax_number": "713-486-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8687 LOUETTA RD STE 100",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773796674",
            "telephone_number": "281-370-4034",
            "fax_number": "281-374-8251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4185 Technology Forest Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "The Woodlands",
            "state": "TX",
            "postal_code": "773812004",
            "country_code": "US",
            "telephone_number": "281-370-4034",
            "fax_number": "281-374-8251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALANDRAN",
        "first_name": "STEVEN",
        "middle_name": "SPENSER",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-22",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "38331",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "TX",
            "license": "38331",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring, TX

Sources for this page

Verify at the official NPI Registry.