Scott L Ballard, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21307 Issued in TX

Practice address

701 W Bailey Boswell Rd
Saginaw, TX 76179-1007

Phone

(817) 367-6453

Fax

(817) 847-1194

NPI assigned

Apr 23, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

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

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335139200000",
    "number": "1861759268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W BAILEY BOSWELL RD",
            "city": "SAGINAW",
            "state": "TX",
            "postal_code": "761791007",
            "telephone_number": "817-367-6453",
            "fax_number": "817-847-1194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W BAILEY BOSWELL RD",
            "city": "SAGINAW",
            "state": "TX",
            "postal_code": "761791007",
            "telephone_number": "817-367-6453",
            "fax_number": "817-847-1194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "SCOTT",
        "middle_name": "L",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-23",
        "last_updated": "2012-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "21307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Elissa Yvonne Beckham
• Rene Elizabeth Bedrich, PA-C
• Dawn Jeanine Benard, APRN, FNP-C
• Alysia Marie Bertlesman

• General Practice Dentistry in Saginaw, TX
• Providers in Saginaw, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2012; 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.