KENNETH H. BALLENTINE OD INC. NPI 1649448507

NPI Information

NPI: 1649448507
Provider Name: KENNETH H. BALLENTINE OD INC.
Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization
Address:
5275 PROSPECT RD
SAN JOSE, CA
ZIP 95129
Phone: (408) 255-0576
Get Directions

KENNETH H. BALLENTINE OD INC. is an eyewear supplier in San Jose, CA. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. KENNETH H. BALLENTINE OD INC. NPI is 1649448507. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5275 PROSPECT RD
SAN JOSE, CA
ZIP 95129-031
Phone: (408) 255-0576

The provider's authorized official is Kenneth H Ballentine .
The authorized official title is Doctor and has the following contact phone number (408) 255-0576.

The enumeration date for this NPI number is 2/13/2008 and was last updated on 9/6/2012.

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
1	152W00000X	Optometrist		6863T	CALIFORNIA	No
2	332H00000X	Eyewear Supplier		6863T	CALIFORNIA	Yes

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
1	0154770001	MEDICARE NSC	CALIFORNIA
2	T10429	MEDICARE UPIN
3	SD0068630	MEDICAID	CALIFORNIA
4	FS797A	MEDICARE PIN

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: 4/28/2024

NPI Synchronization or Removal

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