NPIMap

Organization Active NPI

Jason E Baker DDS LLC

Doing business as Miramar Beach Dental & Orthodontics

  • General Practice Dentistry
  • Miramar Beach, FL
National Provider Identifier
1093051344
Registry record updated Jun 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
17784 Issued in FL
Legal business name
JASON E BAKER DDS LLC
Doing business as
Miramar Beach Dental & Orthodontics
Practice address
77 South Shore Drive
Miramar Beach, FL 32550
Phone
(850) 650-2070
Fax
(850) 650-2073
NPI assigned
Dec 13, 2012
Last updated
Jun 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2015

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

Authorized official

Name
Danielle S Daugherty
Title
Practice Administrator
Phone
(850) 650-2070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 17784 FL Primary

Addresses

Primary practice location

77 South Shore Drive
Miramar Beach, FL 32550

Mailing address

77 S Shore Dr
Miramar Beach, FL 32550-4967
Phone (850) 650-2070

Other names 1

  • Miramar Beach Dental & Orthodontics Doing business as

National Provider Directory

National Provider Directory

Locations

77 S Shore Dr
Miramar Beach, FL 32550
Phone (850) 262-9488

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1355356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435622400000",
    "number": "1093051344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 S SHORE DR",
            "city": "MIRAMAR BEACH",
            "state": "FL",
            "postal_code": "325504967",
            "telephone_number": "850-650-2070",
            "fax_number": "850-650-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 SOUTH SHORE DRIVE",
            "city": "MIRAMAR BEACH",
            "state": "FL",
            "postal_code": "32550",
            "telephone_number": "850-650-2070",
            "fax_number": "850-650-2073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON E BAKER DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-13",
        "last_updated": "2015-06-30",
        "status": "A",
        "authorized_official_last_name": "DAUGHERTY",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "850-650-2070"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "17784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Miramar Beach Dental & Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miramar Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2015; 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.