Active NPI
Thanakorn Baker
- Pediatric Dentistry
- Hillsboro, OR
National Provider Identifier
1053064451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- D11938
- Practice address
- 434 S 1St Ave Ste 300
Hillsboro, OR 97123-3957 - Phone
- (503) 967-5017
- NPI assigned
- Jan 27, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | D11938 | OR | Primary |
Addresses
Primary practice location
434 S 1St Ave Ste 300
Hillsboro, OR 97123-3957
Mailing address
434 S 1St Ave Ste 300
Hillsboro, OR 97123-3957
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D11938 | OR | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719792000000",
"number": "1053064451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "434 S 1ST AVE STE 300",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "971233957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "434 S 1ST AVE STE 300",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "971233957",
"telephone_number": "503-967-5017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAKER",
"first_name": "THANAKORN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-01-27",
"last_updated": "2024-07-01",
"certification_date": "2024-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "OR",
"license": "D11938",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hillsboro, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.