Individual provider Active NPI

Anuradha Balaggan, DDS

  • Pediatric Dentistry
  • Van Nuys, CA
National Provider Identifier
1922749423
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
110054 Issued in CA
Practice address
6822 Van Nuys Blvd
Van Nuys, CA 91405-4625
Phone
(747) 377-4601
NPI assigned
Apr 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 110054 CA Primary

Addresses

Primary practice location

6822 Van Nuys Blvd
Van Nuys, CA 91405-4625

Mailing address

6822 Van Nuys Blvd
Van Nuys, CA 91405-4625
Phone (443) 944-7250

Other practice location 1

650 W Baltimore St
Baltimore, MD 21201-1510
Phone (410) 706-7970

Other practice location 2

16658 Soledad Canyon Rd
Santa Clarita, CA 91387-3217
Phone (661) 383-0045

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20220817002208 MD Order and Referring Only - DentistPractitioner - Dentist 4385027747

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17642MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rodef Dental Office of Santa Clarita PastSince Apr 14, 2024 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": "1649203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1922749423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6822 VAN NUYS BLVD",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914054625",
            "telephone_number": "443-944-7250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6822 VAN NUYS BLVD",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914054625",
            "telephone_number": "747-377-4601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 W Baltimore St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212011510",
            "country_code": "US",
            "telephone_number": "410-706-7970",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16658 Soledad Canyon Rd",
            "address_purpose": "LOCATION",
            "city": "Santa Clarita",
            "state": "CA",
            "postal_code": "913873217",
            "country_code": "US",
            "telephone_number": "661-383-0045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALAGGAN",
        "first_name": "ANURADHA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-06",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "110054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.