Active NPI
Lauren Jean Bales, DDS
- General Practice Dentistry
- Mountain Grove, MO
National Provider Identifier
1851501423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2003001288
- Practice address
- 1604 C North Main Street
Mountain Grove, MO 65711-0000 - Phone
- (417) 926-1209
- Fax
- (417) 683-1602
- NPI assigned
- May 23, 2007
- Last updated
- Feb 3, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2003001288 | MO | Primary |
Addresses
Primary practice location
1604 C North Main Street
Mountain Grove, MO 65711-0000
Mailing address
PO Box 1359
Ava, MO 65608-1359
Phone (417) 683-4831
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851501423 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2003001288 | MO | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454457600000",
"number": "1851501423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1359",
"city": "AVA",
"state": "MO",
"postal_code": "656081359",
"telephone_number": "417-683-4831",
"fax_number": "417-683-1602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1604 C NORTH MAIN STREET",
"city": "MOUNTAIN GROVE",
"state": "MO",
"postal_code": "657110000",
"telephone_number": "417-926-1209",
"fax_number": "417-683-1602"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALES",
"first_name": "LAUREN",
"middle_name": "JEAN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-23",
"last_updated": "2016-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MO",
"license": "2003001288",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1851501423",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mountain Grove, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.