Baxter, Ksenia G.

Baxter, Ksenia G. is an individual health care provider with primary practice located at 2 Stony Hill Rd , Bethel CT 06801. She recently has 3 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Dental Providers / General Practice, Dental Providers / Periodontics. Dental Providers / Periodontics is her primary health care specialty. Baxter, Ksenia G. can be contacted via phone (203) 792-2263.

Contact Information

Primary practice address
2 Stony Hill Rd Bethel CT 06801
Phone: (203) 792-2263
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Dental Providers / General Practice 1223G0001X 10812 Connecticut
Dental Providers / Periodontics 1223P0300X 10812 Connecticut

Profile Details

NPI number 1467749283
LBN Legal business name Baxter, Ksenia G.
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2011
Last updated May 23rd, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467749283 NPPES
Connecticut MEDICAID 004011136

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