Fareeda Bacchus, DDS, MS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

33831 Issued in TX

Practice address

2121 E Oltorf St
Austin, TX 78741-4500

Phone

(949) 800-9524

NPI assigned

Jul 27, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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

• Dental One Associates Cross Keys PC

  • Dentist
  • Baltimore, MD
  • NPI 1689799868
  NPD (past)
• Freeman & Freeman ,P.C

  • General Practice Dentistry
  • Jersey City, NJ
  • NPI 1801161815
  NPD (past)

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

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1053864983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 E OLTORF ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787414500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 E OLTORF ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787414500",
            "telephone_number": "949-800-9524"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2403 Kennedy Blvd",
            "address_purpose": "LOCATION",
            "city": "Jersey City",
            "state": "NJ",
            "postal_code": "073041909",
            "country_code": "US",
            "telephone_number": "201-332-1664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACCHUS",
        "first_name": "FAREEDA",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-27",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "33831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Babylon Healthcare, P.C.
• Babylon Healthcare, PLLC
• Jennifer Merrill Baca Davila, LPC
• Elijah Baca
• Waleska Citlaly Baca
• Taylor Baccus, PA-C
• Caroline Bach
• John-Paul Brocato Bach, MD
• Michaela Bach, RDN, CD
• Michelle Songin Bach

• General Practice Dentistry in Austin, TX
• Providers in Austin, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.