Individual provider Active NPI

Justin Lee Baltz, D.D.S

  • Dentist
  • Aurora, CO
National Provider Identifier
1902125578
Registry record updated Jan 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10422 Issued in CO
Practice address
3574 S Tower Rd
Ste B
Aurora, CO 80013-3561
Phone
(303) 617-9100
Fax
(303) 617-9198
NPI assigned
May 21, 2010
Last updated
Jan 24, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10422 CO Primary

Addresses

Primary practice location

3574 S Tower Rd
Ste B
Aurora, CO 80013-3561

Mailing address

3574 S Tower Rd
Ste B
Aurora, CO 80013-3561
Phone (303) 617-9100

Other identifiers 1

IdentifierTypeStateIssuer
364295MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20231227002485 CO Order and Referring Only - DentistPractitioner - Dentist 0941529556

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10422COMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Rowe and Baltz Dental, PLLC Past Accepting new patients
Merril F Rowe DDS PC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1274400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1902125578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3574 S TOWER RD",
            "address_2": "STE B",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800133561",
            "telephone_number": "303-617-9100",
            "fax_number": "303-617-9198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3574 S TOWER RD",
            "address_2": "STE B",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800133561",
            "telephone_number": "303-617-9100",
            "fax_number": "303-617-9198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALTZ",
        "first_name": "JUSTIN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-21",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "10422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "364295",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.