Ravi Balu DMD PC

Primary specialty

DentistTaxonomy code 122300000X

License

DS027029L Issued in PA

Legal business name

RAVI BALU DMD PC

Practice address

210 Laurel Dr
Connellsville, PA 15425-3869

Phone

(724) 628-9340

Fax

(724) 628-4090

NPI assigned

Apr 22, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Carol Foster

Title

Office Manager

Phone

(724) 628-9340

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214524800000",
    "number": "1942474879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 LAUREL DR",
            "city": "CONNELLSVILLE",
            "state": "PA",
            "postal_code": "154253869",
            "telephone_number": "724-628-9340",
            "fax_number": "724-628-4090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 LAUREL DR",
            "city": "CONNELLSVILLE",
            "state": "PA",
            "postal_code": "154253869",
            "telephone_number": "724-628-9340",
            "fax_number": "724-628-4090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVI BALU DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-06-27",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "724-628-9340",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS027029L",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS015819L",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS037382",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS031148L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Connellsville, PA
• Providers in Connellsville, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; 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.