Angela Marie Baudean, D.M.D
Individual provider Active NPI General Practice Dentistry · Gautier, MS
NPI 1124409388 · NPPES record last updated Oct 23, 2023
Key facts
- NPI
- 1124409388
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 3806-15 (MS)
- Practice address
- 713 Highway 90
Gautier, MS 39553-5609 - Phone
- (228) 201-3621
- NPI assigned
- Jun 13, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3806-15 | MS | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Mississippi Smiles Dentistry LLC | General Practice | Past |
Accepting new patients |
| Farley Family Dentistry LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 3806-15 | MS | Yes |
Addresses
Primary practice location
713 Highway 90
Gautier, MS 39553-5609
Mailing address
713 Highway 90
Gautier, MS 39553-5609
Phone (228) 201-3601
Other providers in Gautier, MS
- Alexis Nicole Banus
- Nicolette Rose Barberi
- Christina A Baria
- Anicia Leatrice Barnes
- Joannie Michelle Bartlett
- Austin Bradley Beach
- Johneshia Patrice Beckham
- Pamela Rae Benjaman
- Michael Bierdeman
- Biloxi Regional Medical Center
All providers in Gautier, MS · General Practice Dentistry in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 23, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.