MEDICARE: ELLEN VANDERGUST 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	1223G0001X	General Practice Dentistry	1668	NM

General Provider Information

NPI Number	:	1649452129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLEN VANDERGUST BALLARD DDS

Provider Business Mailing Address
First Line	:	111 LONGVIEW
Second Line	:	SUITE B-3
City	:	WHITE ROCK
State	:	NM
Zip	:	87544
Country	:	US
Telephone Number	:	505-672-2020
Fax Number	:	505-672-2020

Provider Business Practice Location Address
First Line	:	111 LONGVIEW
Second Line	:	SUITE B-3
City	:	WHITE ROCK
State	:	NM
Zip	:	87544
Country	:	US
Telephone Number	:	505-672-2020
Fax Number	:	505-672-2020

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

Provider Enumeration Date	:	11/27/2007
Last Update Date	:	11/27/2007

Similar Medicare Providers

1457376071 — SMITHS FOOD & DRUG CENTERS INC
Practice Location Address:

31 SHERWOOD BLVD
WHITE ROCK, NM
87544-3730

Practice Phone: 505-672-9457
Practice Fax: 505-672-1519

1215942826 — LAMC WHITE ROCK PHARMACY
Practice Location Address:

WHITE ROCK MED CLINIC STE B
WHITE ROCK, NM
87544

Practice Phone: 505-672-3701
Practice Fax: 505-672-0369

1013367291 — RITA ANNE SENATOR RN, MSN
Practice Location Address:

1265 BIG ROCK LOOP
LOS ALAMOS, NM
87544-2852

Practice Phone: 505-500-6575
Practice Fax:

1124809595 — NIKO HEALTHCARE SERVICES, LLC
Practice Location Address:

16316 WHITE ROCK BLVD
PROSPER, TX
75078-5059

Practice Phone: 424-426-7635
Practice Fax:

1952547994 — MRS. SARAH ELIZABETH BETTERS M.S.W. LICSW
Practice Location Address:

1 WHITE ROCK PATH
CARVER, MA
02330-1266

Practice Phone: 508-474-9256
Practice Fax:

1356204630 — EDWIN PARK
Practice Location Address:

11000 WHITE ROCK RD
RANCHO CORDOVA, CA
95670-6010

Practice Phone: 800-977-2273
Practice Fax:

Directions to “ ELLEN VANDERGUST BALLARD DDS” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.