Eric Frederick Bauman, DMD, MS
Individual provider Active NPI Dentist · Taos, NM
NPI 1114017209 · NPPES record last updated Sep 25, 2024
Key facts
- NPI
- 1114017209
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DN24628 (FL)
- Practice address
- 1090 Goat Springs Road
Taos, NM 87571 - Phone
- (575) 758-6955
- NPI assigned
- Oct 13, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240607000598 | TX | Practitioner - Dentist | 0042752883 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D8840 | OR | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Taos Picuris Health Center | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D8840 | OR | |
| Dentist | 122300000X | DN24628 | FL | Yes |
Addresses
Primary practice location
1090 Goat Springs Road
Taos, NM 87571
Mailing address
1090 Goat Springs Road
Taos, NM 87571
Phone (575) 758-6955
Other providers in Taos, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.