Ayman A Balshe, DDS, MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

57041 Issued in CA

Practice address

2115 E Viking Ave
Anaheim, CA 92806-4655

Phone

(612) 805-9505

NPI assigned

Jan 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313020800000",
    "number": "1790839629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 E VIKING AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928064655",
            "telephone_number": "612-805-9505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 E VIKING AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928064655",
            "telephone_number": "612-805-9505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALSHE",
        "first_name": "AYMAN",
        "middle_name": "A",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2011-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MN",
            "license": "D12354",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "57041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268487000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Ann Ball, MA
• Marina A. Ball, MD
• Piya Lilo Ballani, MD
• Fanta Ballard
• Melissa Ballon
• John Baltazar, MD
• Maria Donna Baltazar, MOTR/L
• Sophia Micaela Bambao
• Karina Banda
• Omar Banda

• Periodontics in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.