Individual provider Active NPI

Dakota Rex Baker, DDS

  • General Practice Dentistry
  • Kellogg, ID
National Provider Identifier
1104682301
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D-5623 Issued in ID
Practice address
109 McKinley Ave
Kellogg, ID 83837-2501
Phone
(208) 881-2575
NPI assigned
Feb 26, 2024
Last updated
Sep 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D-5623 ID Primary

Addresses

Primary practice location

109 McKinley Ave
Kellogg, ID 83837-2501

Mailing address

715 Castlerock LN
Idaho Falls, ID 83404-7997
Phone (208) 881-2575

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

LicenseStateTypeSpecialty
D-5623IDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dakota Baker DDS PLLS General Practice CurrentSince Jun 29, 2025 Accepting new patients

Locations

109 McKinley Ave
Kellogg, ID 83837
Phone (208) 784-0545

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1104682301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 CASTLEROCK LN",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047997",
            "telephone_number": "208-881-2575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 MCKINLEY AVE",
            "city": "KELLOGG",
            "state": "ID",
            "postal_code": "838372501",
            "telephone_number": "208-881-2575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "DAKOTA",
        "middle_name": "REX",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-26",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-5623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kellogg, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2025; 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.