Randall Glenn Baldwin, DMD
Individual provider Active NPI Dentist · Ridgefield, CT
NPI 1043556046 · NPPES record last updated Dec 19, 2012
Key facts
- NPI
- 1043556046
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DO 4074 (CT)
- Practice address
- 42 Danbury Rd
Ridgefield, CT 06877-4019 - Phone
- (203) 438-7181
- NPI assigned
- Dec 19, 2012
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO 4074 | CT | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Randall G Baldwin DMD PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DO 4074 | CT | Yes |
Addresses
Primary practice location
42 Danbury Rd
Ridgefield, CT 06877-4019
Mailing address
43 E Ridge Rd
Ridgefield, CT 06877-5017
Phone (203) 438-5174
Other providers in Ridgefield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 19, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.