Individual provider Active NPI

Abhilasha Bal, DDS

  • General Practice Dentistry
  • San Francisco, CA
National Provider Identifier
1992350466
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
104143 Issued in CA
Practice address
3532 20TH St
San Francisco, CA 94110-2419
Phone
(415) 643-6424
NPI assigned
Aug 1, 2019
Last updated
Apr 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 104143 CA Primary

Addresses

Primary practice location

3532 20TH St
San Francisco, CA 94110-2419

Mailing address

3532 20TH St
San Francisco, CA 94110-2419

Other practice location 1

1321 S Eliseo Dr
Greenbrae, CA 94904-2024
Phone (415) 461-8735

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
104143CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Abhilasha Bal Dental Corporation CurrentSince Oct 6, 2024 Accepting new patients
Abhilasha Bal, D.D.S., Inc. CurrentSince Apr 20, 2021 Accepting new patients
Riao-Luque Dental Corp General Practice PastSince Aug 6, 2019 Accepting new patients

Locations

2299 Post St
Ste 101
San Francisco, CA 94115
Phone (415) 346-4488

3532 20th St
San Francisco, CA 94110
Phone (415) 643-6424

Organizations & group practices 3

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": "1564617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1992350466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3532 20TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941102419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3532 20TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941102419",
            "telephone_number": "415-643-6424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1321 S Eliseo Dr",
            "address_purpose": "LOCATION",
            "city": "Greenbrae",
            "state": "CA",
            "postal_code": "949042024",
            "country_code": "US",
            "telephone_number": "415-461-8735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAL",
        "first_name": "ABHILASHA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-01",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "104143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; 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.