MEDICARE: DR. STEVE D BALLARD DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	7025	TN
2	1223G0001X	General Practice Dentistry	7025	TN

General Provider Information

NPI Number	:	1487713681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVE D BALLARD DDS

Provider Business Mailing Address
First Line	:	2900 KIRBY RD
Second Line	:	SUITE 12
City	:	MEMPHIS
State	:	TN
Zip	:	38119-8221
Country	:	US
Telephone Number	:	901-756-8976
Fax Number	:	901-756-8547

Provider Business Practice Location Address
First Line	:	2900 KIRBY RD
Second Line	:	SUITE 12
City	:	MEMPHIS
State	:	TN
Zip	:	38119-8221
Country	:	US
Telephone Number	:	901-756-8976
Fax Number	:	901-756-8547

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2006
Last Update Date	:	01/23/2024

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