Individual provider Active NPI

Thomas J. Balazs, D.D.S.

  • General Practice Dentistry
  • Tonawanda, NY
National Provider Identifier
1861663718
Registry record updated Mar 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
045967-1 Issued in NY
Practice address
432 Delaware St
Tonawanda, NY 14150-3946
Phone
(716) 692-4242
Fax
(716) 694-5774
NPI assigned
Mar 19, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 045967-1 NY Primary

Addresses

Primary practice location

432 Delaware St
Tonawanda, NY 14150-3946

Mailing address

432 Delaware St
Tonawanda, NY 14150-3946
Phone (716) 692-4242

Other identifiers 1

IdentifierTypeStateIssuer
02842193MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20160106000776 NY Order and Referring Only - DentistPractitioner - Dentist 8527360684

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
045967-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
James a. Hoddick, D.D.S. & Thomas J. Balazs, D.D.S., L.L.P. General Practice Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205884800000",
    "number": "1861663718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 DELAWARE ST",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141503946",
            "telephone_number": "716-692-4242",
            "fax_number": "716-694-5774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 DELAWARE ST",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141503946",
            "telephone_number": "716-692-4242",
            "fax_number": "716-694-5774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALAZS",
        "first_name": "THOMAS",
        "middle_name": "J.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-19",
        "last_updated": "2008-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "045967-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02842193",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tonawanda, NY

Sources for this page

Verify at the official NPI Registry.