Blake Ballenger, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DEN.00204239 Issued in CO

Practice address

300 E 128TH Ave
Thornton, CO 80241-2427

Phone

(303) 451-6767

NPI assigned

Jul 19, 2016

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Colorado Surgical Arts

  dba Precision Oral Surgery

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Englewood, CO
  • NPI 1952677973
  NPD (past)

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1861845539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E 128TH AVE",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802412427",
            "telephone_number": "303-451-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E 128TH AVE",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802412427",
            "telephone_number": "303-451-6767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6323 Howe St",
            "address_2": "Apt. 2",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152064816",
            "country_code": "US",
            "telephone_number": "765-437-5634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALLENGER",
        "first_name": "BLAKE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-19",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CO",
            "license": "DEN.00204239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hailey Sue Baldrey
• Frank Baldwin, PAC
• Merri E Baldwin
• Steven Ball, LMT
• Grace Ballard
• Sarah Balsamo
• Alisa Nichole Baneck Bahl
• Christopher M Bannigan
• Ann Barbour
• Amy Barcenas

• Oral and Maxillofacial Surgery (Dentist) in Thornton, CO
• Providers in Thornton, CO by specialty
• Oral and Maxillofacial Surgery (Dentist) in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.