FRED L BALLOU DMD PSC NPI 1619972205

NPI Information

  • NPI: 1619972205
  • Provider Name: FRED L BALLOU, DMD, PSC
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 311 RADIO PARK DR
    STE B
    RICHMOND, KY
    ZIP 40475
  • Phone: (859) 623-3818

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NPI Details

FRED L BALLOU, DMD, PSC is a general practice dentist in Richmond, KY. The provider is 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. FRED L BALLOU, DMD, PSC NPI is 1619972205. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

311 RADIO PARK DR
STE B
RICHMOND, KY
ZIP 40475-399
Phone: (859) 623-3818
Fax: (859) 624-1061

The provider's authorized official is Fred L Ballou .
The authorized official title is President/owner and has the following contact phone number (859) 623-3818.

The enumeration date for this NPI number is 6/20/2005 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice3905KENTUCKYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1532067OTHERKENTUCKYUNITED CONCORDIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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