Stephanieballentine,DDS,PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4831 Issued in NC

Legal business name

STEPHANIEBALLENTINE,DDS,PA

Practice address

1315 Matheson Ave
Charlotte, NC 28205-1670

Phone

(704) 334-6907

Fax

(704) 376-4773

NPI assigned

May 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Stephanie Ballentine, DDS

Title

President

Phone

(704) 334-6907

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851504609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 MATHESON AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282051670",
            "telephone_number": "704-334-6907",
            "fax_number": "704-376-4773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 MATHESON AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282051670",
            "telephone_number": "704-334-6907",
            "fax_number": "704-376-4773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHANIEBALLENTINE,DDS,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BALLENTINE",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-334-6907",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "4831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8990381",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Stephen W. Hipp, M.D., P.a.
• Stephens McQueen Holdings LLC

• General Practice Dentistry in Charlotte, NC
• Providers in Charlotte, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.