Provider Demographics
NPI:1487713681
Name:BALLARD, STEVE D (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVE
Middle Name:D
Last Name:BALLARD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 KIRBY RD
Mailing Address - Street 2:SUITE 12
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-8221
Mailing Address - Country:US
Mailing Address - Phone:901-756-8976
Mailing Address - Fax:901-756-8547
Practice Address - Street 1:2900 KIRBY RD
Practice Address - Street 2:SUITE 12
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-8221
Practice Address - Country:US
Practice Address - Phone:901-756-8976
Practice Address - Fax:901-756-8547
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7025122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist