Andrew James Balaze, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

2901020967 Issued in MI

Practice address

306 W Washington Ave Ste 205
Jackson, MI 49201-2141

Phone

(517) 787-5055

NPI assigned

Jun 16, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dentistry by Design of Jackson, PLC

  • Dentist
  • Jackson, MI
  • NPI 1396276333
  NPD Authorized official
• Frederic B Slete D.D.S.,PC

  • General Practice Dentistry
  • Jackson, MI
  • NPI 1740379015
  NPD (past)
• Melissa K Renz DDS PLC

  dba Pear Tree Dental

  • General Practice Dentistry
  • Saline, MI
  • NPI 1184087470
  NPD (past)
• Pear Tree Dental

  • Dentist
  • Saline, MI
  • NPI 1689076341
  NPD (past)

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

{
    "created_epoch": "1371340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1851730592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 W WASHINGTON AVE STE 205",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012141",
            "telephone_number": "517-787-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 W WASHINGTON AVE STE 205",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012141",
            "telephone_number": "517-787-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALAZE",
        "first_name": "ANDREW",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-16",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MI",
            "license": "2901020967",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nichole Baker
• Stacy Baker, LPN
• Travis Baker
• Balanced Body Chiropractic & Massage, LLC
• Balanced Life Counseling LLC
• Willy C Baldwin, LLC
• Mark Frederick Balino, D.O.
• Muna Balkash, M.D.
• Steven Lee Ball, MSW, LCSW
• Melissa Ballard

• Dentist in Jackson, MI
• Providers in Jackson, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; 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.