Active NPI
Marc Lee Ball, DDS
- Dentist
- Wenatchee, WA
National Provider Identifier
1932217726
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 5215
- Practice address
- 620 N Emerson St
Ste 103
Wenatchee, WA 98801-6619 - Phone
- (509) 662-9685
- Fax
- (509) 662-5099
- NPI assigned
- Aug 29, 2006
- Last updated
- Apr 23, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 5215 | WA | Primary |
Addresses
Primary practice location
620 N Emerson St
Ste 103
Wenatchee, WA 98801-6619
Mailing address
620 N Emerson St
Ste 103
Wenatchee, WA 98801-6619
Phone (509) 662-9685
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6729430001 | Other | WA | MEDICARE PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5215 | WA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael P Potter DDS PLLC | Dentist | 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, 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": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366675200000",
"number": "1932217726",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 N EMERSON ST",
"address_2": "STE 103",
"city": "WENATCHEE",
"state": "WA",
"postal_code": "988016619",
"telephone_number": "509-662-9685",
"fax_number": "509-662-5099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 N EMERSON ST",
"address_2": "STE 103",
"city": "WENATCHEE",
"state": "WA",
"postal_code": "988016619",
"telephone_number": "509-662-9685",
"fax_number": "509-662-5099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALL",
"first_name": "MARC",
"middle_name": "LEE",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2013-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "5215",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "6729430001",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wenatchee, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.