Adwoa Boateng Baidoo
Individual provider Active NPI Dentist · Rockingham, VA
NPI 1053085191 · NPPES record last updated Aug 3, 2021
Key facts
- NPI
- 1053085191
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 0401417571 (VA)
- Practice address
- 4100 Quarles CT
Rockingham, VA 22801-8797 - Phone
- (703) 206-8504
- NPI assigned
- Aug 3, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 0401417571 | VA | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | 0401417571 | VA | Yes |
Addresses
Primary practice location
4100 Quarles CT
Rockingham, VA 22801-8797
Mailing address
1270 Constitution CT
Apt 102
Harrisonburg, VA 22802
Phone (703) 206-8504
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0401417571 | Other | VA | DENTAL LICENSE NUMBER |
Other providers in Rockingham, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 3, 2021. 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.