Individual provider Active NPI

Jonathan Peter Bayne, D.D.S

  • Dentist
  • Colorado Springs, CO
National Provider Identifier
1164409363
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9338 Issued in CO
Practice address
1045 E Stewart Ave BLDG 2012T
Colorado Springs, CO 80914-2900
Phone
(719) 556-1333
NPI assigned
Dec 28, 2005
Last updated
May 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9338 CO Primary

Addresses

Primary practice location

1045 E Stewart Ave BLDG 2012T
Colorado Springs, CO 80914-2900

Mailing address

1045 E Stewart Ave BLDG 2012T
Colorado Springs, CO 80914-2900
Phone (719) 556-1333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20150211000394 CO Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9436474640

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
BDC, LLC Past Accepting new patients
Colorado Laser Dentistry, PC Dentist Past Accepting new patients

Organizations & group practices 2

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": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1164409363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 E STEWART AVE BLDG 2012T",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809142900",
            "telephone_number": "719-556-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 E STEWART AVE BLDG 2012T",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809142900",
            "telephone_number": "719-556-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYNE",
        "first_name": "JONATHAN",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "9338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.