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 | 
|---|
| Gender | Female | 
|---|
| Speciality | Dentist - General Practice | 
|---|
| Location | 111 Longview, White Rock, New Mexico | 
|---|
| 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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