BALLANCE & DEROSE DDS PA (NPI# 1053344630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053344630 |
| Entity Type | Organization |
| Organization Name | BALLANCE & DEROSE DDS PA |
| Practice Address |
900 Summit Ave Greensboro NC 27405-7918 |
| Mailing Address |
2041 Silas Creek Pkwy Winston Salem NC 27103-5147 |
| Practice Telephone | 3363701112 |
| Practice Fax Number | 3365440739 |
| Mailing Telephone | 3367770303 |
| Mailing Fax Number | 3367773448 |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. MICHAEL ANTHONY DEROSE (OWNER) |
| Authorized Official Telephone | 3367770303 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5903666 | 05 | |
| BLUE CROSS BLUE SHIELD NC | 018CY | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982632535 | Ballance & Derose Dds Pa | Dentist | 247 Biltmore Ave, Asheville, NC 28801-4107 | 2006-06-30 |
| 1386677961 | Ballance & Derose Dds Pa | Dentist | 1400 Walter Reed Rd, Suite 200, Fayetteville, NC 28304-4409 | 2006-07-08 |
| Street Address |
900 SUMMIT AVE |
| City | GREENSBORO |
| State | NC |
| Zip Code | 27405-7918 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891122115 | Gabriela Akuabia Nwobu | Dentist | 900 Summit Ave, Greensboro, NC 27405-7918 | 2013-10-01 |
| 1982873899 | Rafael Rivera, Jr., Dds, Pllc | Dentist | 900 Summit Ave, Greensboro, NC 27405-7918 | 2008-02-25 |
| 1568657492 | Elysa Bailey Demorais | Dentist | 900 Summit Ave, Greensboro, NC 27405-7918 | 2007-09-13 |
| 1740354810 | Peeranan S Lee | Dentist | 900 Summit Ave, Greensboro, NC 27405-7918 | 2006-11-20 |
| 1649387382 | Jacquese Olean Black | Dentist | 900 Summit Ave, Greensboro, NC 27405-7918 | 2006-08-25 |
| 1376651042 | Carmen Lianne Leary | Dentist | 900 Summit Ave, Greensboro, NC 27405-7918 | 2006-08-25 |
| 1932124278 | Felicia Angeline Mcneal | Dentist | 900 Summit Ave, Greensboro, NC 27405-7918 | 2006-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477038727 | Miya Jackson | Behavior Technician | 2308 Golden Gate Dr, Apt G, Greensboro, NC 27405 | 2018-10-02 |
| 1821576299 | Woodrow Eric Bradley | Day Training/Habilitation Specialist | 1403 Woocbriar Ave, Greensboro, NC 27405 | 2018-07-30 |
| 1922593094 | Constance Foushee | Nurse Practitioner | 1100 E. Wendover, Greensboro, NC 27405 | 2018-06-29 |
| 1760972434 | Ayana Linette Holland | Home Health Aide | 1417 Old Hickory Dr, Greensboro, NC 27405 | 2018-05-17 |
| 1790294700 | G. Antoine Gray | Specialist | 2100 Phillips Avenue, Suite B, Greensboro, NC 27405 | 2017-09-21 |
| 1306375910 | Wendy Carisa Boger | Registered Nurse | 1100 East Wendover Avenue, Greensboro, NC 27405 | 2017-06-07 |
| 1659827715 | Changing Paths Counseling Center Pllc | Community/Behavioral Health | 1600 E Wendoer Ave., Suite C, Greensboro, NC 27405 | 2016-08-29 |
| 1295187896 | Amanda Kirby Counseling, PC | Counselor | 1175 Revolution Mill Drive, Suite 29-2, Greensboro, NC 27405 | 2016-07-07 |
| 1780049429 | Pta | Residential Treatment Facility, Physical Disabilities | 1900 Sheldon Road, Greensboro, NC 27405 | 2015-12-23 |
| 1841655644 | Amaya Nicole Hardy | Counselor | 1600r E Wendover Ave Ste R, Greensboro, NC 27405 | 2015-12-21 |
| Find all providers in zip 27405 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467076976 | Vanessa Catherina Knox | Dentist | 4496 Veranda Lake Ct, Greensboro, NC 27409-9244 | 2020-05-31 |
| 1710522065 | Georgia Dental Alliance of Greensboro | Dentist | 1041 Parkside Cmns Ste 104, Greensboro, GA 30642-4519 | 2019-11-11 |
| 1720632946 | Elizabeth B Mcmichael | Dentist | 2321 Battleground Ave, Greensboro, NC 27408-5422 | 2019-07-25 |
| 1609347731 | Thomas J Bagley D.d.s., P.a. | Dentist | 2729 Horse Pen Creek Rd Ste 103, Greensboro, NC 27410-8396 | 2018-12-16 |
| 1063904506 | Jonathan Hunt | Dentist | 5506 W Friendly Ave Ste 101, Greensboro, NC 27410 | 2018-05-31 |
| 1578054557 | Koelling Johnstun & Associates Pllc | Dentist | 2643 Randleman Rd, Greensboro, NC 27406-5153 | 2018-05-24 |
| 1891293205 | Drs Roberts Reimels and Kashyap Pllc | Dentist | 1126 N Church St Ste 102, Greensboro, NC 27401-1035 | 2018-01-31 |
| 1689031783 | M. Thomas Jones Dmd, Pa | Dentist | 5710 W Gate City Blvd Ste R, Greensboro, NC 27407-7047 | 2016-01-20 |
| 1255710646 | Travis Andrew Bell | Dentist | 526 N Elam Ave Ste 201, Greensboro, NC 27403-1132 | 2015-05-19 |
| 1104218007 | Koelling & Associates Pllc | Dentist | 510 Nicholas Rd, F, Greensboro, NC 27409-3399 | 2015-03-02 |
| Find all providers in GREENSBORO | ||||
| City | GREENSBORO |
| Zip Code | 27405 |
Please comment or provide details below to improve the information on BALLANCE & DEROSE DDS PA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.