Individual provider Active NPI

Gregory Stephen Balekjian, D.D.S.

  • General Practice Dentistry
  • Hillsboro, OR
National Provider Identifier
1790708139
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D6766 Issued in OR
Practice address
19075 NW Tanasbourne Dr
Ste. 300
Hillsboro, OR 97124-5860
Phone
(503) 531-1700
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D6766 OR Primary

Addresses

Primary practice location

19075 NW Tanasbourne Dr
Ste. 300
Hillsboro, OR 97124-5860

Mailing address

19075 NW Tanasbourne Dr
Ste. 300
Hillsboro, OR 97124-5860
Phone (503) 531-1700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20110721000192 OR Order and Referring Only - DentistPractitioner - Dentist 6002084845

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1790708139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19075 NW TANASBOURNE DR",
            "address_2": "STE. 300",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245860",
            "telephone_number": "503-531-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19075 NW TANASBOURNE DR",
            "address_2": "STE. 300",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245860",
            "telephone_number": "503-531-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALEKJIAN",
        "first_name": "GREGORY",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D6766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

Verify at the official NPI Registry.