Teodora Nikolaeva Baylon, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

D12717 Issued in MN

Practice address

2233 Hamline Ave N
Roseville, MN 55113-5009

Phone

(651) 636-0655

NPI assigned

May 17, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dr. Teodora Nikolaeva Platikanova Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Personal Care Dentistry

  • General Practice Dentistry
  • Roseville, MN
  • NPI 1639713126
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1274054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456185600000",
    "number": "1053639963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 HAMLINE AVE N STE 320",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551135005",
            "telephone_number": "651-636-0655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 HAMLINE AVE N",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551135009",
            "telephone_number": "651-636-0655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYLON",
        "first_name": "TEODORA",
        "middle_name": "NIKOLAEVA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-17",
        "last_updated": "2016-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D12717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TEODORA",
            "last_name": "PLATIKANOVA",
            "middle_name": "NIKOLAEVA",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bruce Dean Bates, DDS
• David Andrew Bates, D.D.S.
• Jennifer Lorain Battaglia, CNP
• John Richard Baudler, MD
• Kirk Roland Baumgardner, DDS, PHD
• Nicholas Aaron Becker, PA-C
• Pamela James Becker, PT
• Robert Matthew Becker, MD
• Nancy Kay S Beckes, LICSW
• Behavioral Health Innovations LLC

• Dentist in Roseville, MN
• Providers in Roseville, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.