Jill Marie Balgaard – General Practice Dentistry

Key facts

NPI: 1972984359
Entity type: Individual (NPI type 1)
Primary specialty: General Practice Dentistry 1223G0001X
License: D13727 (MN)
Practice address: 321 Western Ave
Fergus Falls, MN 56537-2403
Phone: (218) 739-2481
NPI assigned: Jun 11, 2015
Sex: Female
Sole proprietor: No

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.

Lifesmiles Dental LLC General Practice Dentistry · Fergus Falls, MN · NPI 1578893632

NPD (past) GENERAL PRACTICE

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
D13727	MN	MD	General Practice Dentistry
DEN-DEN-LIC-9606	MT	MD	General Practice Dentistry

Practice roles

Organization	Specialty	Status	New patients
Lifesmiles Dental LLC	General Practice	Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
General Practice Dentistry	1223G0001X	D13727	MN	Yes
General Practice Dentistry	1223G0001X	DEN-DEN-LIC-9606	MT

Addresses

Primary practice location

321 Western Ave
Fergus Falls, MN 56537-2403

Mailing address

321 Western Ave
Fergus Falls, MN 56537-2403
Phone (218) 739-2481

Other providers in Fergus Falls, MN

Ricardo P. Ascano, PH.D.
Wesley Asheim
Stephen D Asp, MD
Jenee Babic
Jill Lesly Baldwin, PA-C
Jillene Marie Bantau
Megan Barker, RN, PHN
Margaret M Barnes, M.D.
Steven Alan Bateman, PA-C
Lavonne Faye Beckler, ADULT NURSE PRACTITI

All providers in Fergus Falls, MN · General Practice Dentistry in Minnesota

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2016. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.