Balacky Dental Group, P.C.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BALACKY DENTAL GROUP, P.C.

Practice address

321 N Larchmont Blvd Ste 613
Los Angeles, CA 90004-3051

Phone

(646) 756-9450

NPI assigned

Apr 2, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Peter Balacky, DDSNPI 1164881926

Title

President

Phone

(646) 756-9450

Specialties & licenses 2

Addresses

Other names 1

• Daybreak Dental of California, P.C. Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peter Anthony Balacky, DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Los Angeles, CA
  • NPI 1164881926

  Oral and Maxillofacial Surgery

  NPD Authorized official

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

{
    "created_epoch": "1712016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712016000000",
    "number": "1962254128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 N ST STE 5621",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 N LARCHMONT BLVD STE 613",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900043051",
            "telephone_number": "646-756-9450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALACKY DENTAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-02",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A",
        "authorized_official_last_name": "BALACKY",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "646-756-9450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Daybreak Dental of California, P.C.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sam Bakshian, M.D.
• Aria Baktash
• Jeni Bakula
• Olga Bakun
• Chinmayee Hema Balachandra, MD, MPH
• Peter Anthony Balacky, DDS
• Nadrine Balady-Bouziane, PHARM.D.
• Ma Jonette Panizales Balagtas, PNP
• Regina Banes Balagtas
• Karren Alena Balaian

• Dental Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; 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.