Kenneth J. Bauer, DDS, a Professional Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

KENNETH J. BAUER, DDS, A PROFESSIONAL CORPORATION

Practice address

55 Mission Cir Ste 107
Santa Rosa, CA 95409-5372

Phone

(707) 538-1086

Fax

(707) 538-0934

NPI assigned

Jul 6, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Bauer, DDSNPI 1356506596

Title

President

Phone

(707) 799-1228

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth James Bauer, D.D.S

  • General Practice Dentistry
  • Santa Rosa, CA
  • NPI 1356506596
  NPD Authorized official

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

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657065600000",
    "number": "1114650207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 MISSION CIR STE 107",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954095372",
            "telephone_number": "707-538-1086",
            "fax_number": "707-538-0934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MISSION CIR STE 107",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954095372",
            "telephone_number": "707-538-1086",
            "fax_number": "707-538-0934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH J. BAUER, DDS, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-06",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A",
        "authorized_official_last_name": "BAUER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-799-1228",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane E Kennedy, NP
• Kimberly Anne Kennedy
• Ron Kennedy, M.D.
• Kenne William Kennemer, MFT
• Kyrie Kennemore
• Alex M Kennett
• James Kenney, PHARM.D.
• Scott Kensinger, MS, CCC-SLP
• Anna Kenyon, RN
• Kari Kenyon, AOD COUNSELOR

• General Practice Dentistry in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2022; 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.