Balta Falls, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D009375 Issued in AZ

Legal business name

BALTA FALLS, LLC

Practice address

3125 W Hunt Hwy
Unit 101
San Tan Valley, AZ 85142-9315

Phone

(480) 868-1864

NPI assigned

Jun 18, 2016

Last updated

Jun 18, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

TRILEAL, LLCAs reported in NPPES

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

Authorized official

Name

Jonathon EdwardsNPI 1013377829

Title

Manager

Phone

(480) 868-1864

Specialties & licenses 1

Addresses

Other names 1

• Mountain Vista Dental Care Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jonathon Edwards

  • Dentist
  • Gilbert, AZ
  • NPI 1013377829
  Authorized official Same address or phone

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

{
    "created_epoch": "1466208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466208000000",
    "number": "1821448036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 S ARCO DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852953017",
            "telephone_number": "480-868-1864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 W HUNT HWY",
            "address_2": "UNIT 101",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851429315",
            "telephone_number": "480-868-1864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALTA FALLS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRILEAL, LLC",
        "enumeration_date": "2016-06-18",
        "last_updated": "2016-06-18",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "JONATHON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "480-868-1864"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D009375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain Vista Dental Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Joseph Abayomi Babatunde, RN
• Laura Babb, NP
• Michelle N Badger, LPC
• Tyler James Bagley, CRNA
• Amy Ball, PA-C
• Jamie Baker Banfield, OTD
• Tammika Banks
• Banner Hospital Based Physicians Arizona LLC
• Banner Imaging Associates PLC
• Banner Physician Super Specialists Arizona LLC

• General Practice Dentistry in San Tan Valley, AZ
• Providers in San Tan Valley, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2016; 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.