Baker Pediatric Dentistry
LBN: Baker Pediatric Dentistry, Pllc
Baker Pediatric Dentistry is an health care organization with primary practice located at 1900 John Adams Pkwy , Idaho Falls ID 83401. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is the primary health care specialty.
Baker Pediatric Dentistry, Pllc can be contacted via phone (208) 524-0644, or through Baker, Thomas Cecil via phone (208) 524-0644.
Contact Information
Primary practice address
1900 John Adams Pkwy
Idaho Falls ID 83401
Phone: (208) 524-0644
Fax: (208) 524-6100
Website:
Authorized official contact:
Name: Baker, Thomas Cecil Doctor of Dental Medicine (DMD)
Phone: (208) 524-0644
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | ||
| Dental Providers / Pediatric Dentistry | 1223P0221X |
Profile Details
| NPI number | 1407211725 |
|---|---|
| LBN Legal business name | Baker Pediatric Dentistry, Pllc |
| DBA Doing business as | Baker Pediatric Dentistry |
| Authorized official | Baker, Thomas Cecil Doctor of Dental Medicine (DMD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 31st, 2015 |
| Last updated | Jun 18th, 2020 - about 5 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407211725 | NPPES |
| Idaho | MEDICAID | 28510 |
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