Kristin Baca, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6358 Issued in NV

Practice address

5785 Spring Mountain Rd
Las Vegas, NV 89146-8829

Phone

(702) 677-0184

NPI assigned

Dec 9, 2013

Last updated

Dec 9, 2013By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dentist

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rd Prabhu-Lata K Shete MDS LTDGroup PAC ID 8820994791, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Rd Prabhu-Lata K Shete MDS LTD

  • Multi-Specialty Clinic/Center
  • Las Vegas, NV
  • NPI 1912995309
  Medicare reassignment Care Compare group NPD (past)

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

{
    "created_epoch": "1386547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386547200000",
    "number": "1114358629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5785 SPRING MOUNTAIN RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5785 SPRING MOUNTAIN RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891468829",
            "telephone_number": "702-677-0184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACA",
        "first_name": "KRISTIN",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-09",
        "last_updated": "2013-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "6358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Jacob Baca Jr.
• Carey Mark Baca
• Cynthia Baca
• Jillian Eve Baca, LPN
• Joshua Baca, DPT
• Ashley Bacab-Delacruz
• Heather Kay Bacala, M.D.
• Jose Rosas Bacala, M.D.
• Ivette Maria Bacallao Llanio
• Belkis Bacallao Rodriguez

• General Practice Dentistry in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• General Practice Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.