James Logan Ballard, DDS
Individual provider Active NPI General Practice Dentistry · La Porte, IN
NPI 1831259019 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1831259019
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 6916 (IN)
- Practice address
- 1702 A Street
La Porte, IN 46350-5925 - Phone
- (219) 362-8980
- NPI assigned
- Dec 11, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6916 | IN | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6916 | IN | Yes |
Addresses
Primary practice location
1702 A Street
La Porte, IN 46350-5925
Mailing address
1702 A Street
La Porte, IN 46350-5925
Phone (219) 362-8980
Other providers in La Porte, IN
- Sajja L Babu
- Back to Health Wellness Center, P.C,
- Mary Barbara Backer
- Husam Baki
- Susan Marie Baldwin
- Kristin Balon
- Sheryl Bane
- Andleeb S Bangash
- Tracy Banghart
- Randy Paul Banic
All providers in La Porte, IN · General Practice Dentistry in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.