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DR. BALASUDHA BALADHANDAYUTHAM BDS, MSD
NPI 1932474665
Dentist in Saint Louis, MO

Active since March 13, 2012PECOS Enrolled
1500 PARK AVE, SAINT LOUIS, MO 63104(866) 626-2878 Get Directions Write a Review

NPPES record last updated: October 28, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 17, 2024, Jan 9, 2019, Mar 23, 2016 (3 updates tracked since 2016).

About Dr. Balasudha Baladhandayutham Bds, Msd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. BALASUDHA BALADHANDAYUTHAM BDS, MSD (NPI 1932474665) is an individual dentist in Saint Louis, Missouri, licensed in Virginia (0401418600) and active in the NPI registry since March 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1932474665
Entity TypeIndividualFemale
Primary Taxonomy122300000X
Provider Legal NameDR. BALASUDHA BALADHANDAYUTHAMCredential: BDS, MSD
Location Address1500 PARK AVESaint Louis, MO 63104-3024
Mailing Address3534 Gratiot St Apt 612Saint Louis, MO 63103-2957 · (205) 422-0265
Phone(866) 626-2878
Sole ProprietorNo
Enumeration DateMarch 13, 2012
Last NPPES UpdateOctober 28, 20253 updates tracked since enumeration
NPPES CertifiedOctober 28, 2025
✔ NPI 1932474665 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in VA · 0401418600
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
Also ListedDentist · EndodonticsTaxonomy 1223E0200X · License IA-0008154045 (MO)
1500 PARK AVE, Saint Louis, MO 63104
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Balasudha Baladhandayutham Bds, Msd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$86.32 typical visit price
range $55.65 – $169.38
Typical copayment $21.58 (range $13.91 – $42.34)
Most-billed visit code 99203
Established Patient
$69.50 typical visit price
range $17.76 – $137.92
Typical copayment $17.37 (range $4.44 – $34.48)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

YASMEEN FATIMA
Student in an Organized Health Care Education/Training Program
1500 PARK AVE
SAINT LOUIS, MO 63104
St. Louis City (314) 814-8700
CADEN HEATON
Student in an Organized Health Care Education/Training Program
1500 PARK AVE
SAINT LOUIS, MO 63104
St. Louis City (801) 603-1633
KATHERINE GRACE RUDDELL
Student in an Organized Health Care Education/Training Program
1500 PARK AVE
SAINT LOUIS, MO 63104
St. Louis City (314) 252-8429
IQRA AZFAR
Student in an Organized Health Care Education/Training Program
1500 PARK AVE
SAINT LOUIS, MO 63104
St. Louis City (866) 626-2878
JAMIL SEIDU
Student in an Organized Health Care Education/Training Program
1500 PARK AVE
SAINT LOUIS, MO 63104
St. Louis City (314) 833-2700
ABRAHAM A. HARAKE
Student in an Organized Health Care Education/Training Program
1500 PARK AVE
SAINT LOUIS, MO 63104
St. Louis City (734) 666-8281
FAISAL KHAN
Student in an Organized Health Care Education/Training Program
1500 PARK AVE
SAINT LOUIS, MO 63104
St. Louis City (314) 833-2700
DAKSH DESAI
Counselor (Addiction (Substance Use Disorder))
1500 PARK AVE
SAINT LOUIS, MO 63104
St. Louis City (314) 833-2700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Balasudha Baladhandayutham's NPI number?

The NPI number for Balasudha Baladhandayutham is 1932474665. It was assigned to this individual provider in the NPPES registry on March 13, 2012.

Where is Balasudha Baladhandayutham located?

Balasudha Baladhandayutham practices at 1500 Park Ave, Saint Louis, MO 63104. The listed phone number is (866) 626-2878.

What is Balasudha Baladhandayutham's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Balasudha Baladhandayutham enrolled in Medicare?

Yes. Balasudha Baladhandayutham is registered in the Medicare PECOS enrollment system.

What insurance does Balasudha Baladhandayutham accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 6 other insurers list Balasudha Baladhandayutham as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Balasudha Baladhandayutham was last updated on October 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.