Ellen Vandergust Ballard, DDS is a
Dentist - General Practice based in White Rock, New Mexico. Ellen Vandergust Ballard is licensed to practice in New Mexico (license number 1668) and her current practice location is
111 Longview, Suite B-3, White Rock, New Mexico. She can be reached at her office (for appointments etc.) via phone at
(505) 672-2020.
NPI number for Ellen Vandergust Ballard is 1649452129 and her current mailing address is 111 Longview, Suite B-3, White Rock, New Mexico. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1649452129.
Healthcare Provider's Profile
Full Name | Ellen Vandergust Ballard |
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Gender | Female |
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Speciality | Dentist - General Practice |
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Location | 111 Longview, White Rock, New Mexico |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1649452129
- Provider Enumeration Date: 11/27/2007
- Last Update Date: 11/27/2007
Medical Identifiers
Medical identifiers for Ellen Vandergust Ballard such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1649452129 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | 1668 (New Mexico) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ellen Vandergust Ballard is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Ellen Vandergust Ballard, DDS 111 Longview, Suite B-3, White Rock, NM 87544 Ph: (505) 672-2020 | Ellen Vandergust Ballard, DDS 111 Longview, Suite B-3, White Rock, NM 87544 Ph: (505) 672-2020 |
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