Individual provider Active NPI

Raymond David Baros, D.D.S.

  • General Practice Dentistry
  • Colorado Springs, CO
National Provider Identifier
1194829697
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
104299 Issued in CO
Practice address
513 Kiva Rd
Colorado Springs, CO 80911-1913
Phone
(719) 392-5300
Fax
(719) 392-1093
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 104299 CO Primary

Addresses

Primary practice location

513 Kiva Rd
Colorado Springs, CO 80911-1913

Mailing address

513 Kiva Rd
Colorado Springs, CO 80911-1913
Phone (719) 392-5300

Other identifiers 4

IdentifierTypeStateIssuer
793766OtherCOUNITED CONCORDIA
71215OtherCOBLUE CROSS/BLUE SHIELD
131423MedicaidCO
104299OtherCODELTA DENTAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
104299COMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194829697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 KIVA RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809111913",
            "telephone_number": "719-392-5300",
            "fax_number": "719-392-1093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 KIVA RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809111913",
            "telephone_number": "719-392-5300",
            "fax_number": "719-392-1093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAROS",
        "first_name": "RAYMOND",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "104299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "793766",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "71215",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131423",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "104299",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.