Individual provider Active NPI

John Kenton Baird, DDS

  • General Practice Dentistry
  • Fresno, CA
National Provider Identifier
1205028552
Registry record updated Aug 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
18963 Issued in CA
Practice address
125 E Barstow Ave
Suite 126
Fresno, CA 93710
Phone
(559) 222-5663
Fax
(559) 222-9235
NPI assigned
Aug 10, 2007
Sex
Male
Sole proprietor
Yes

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
18963CAMDFamily Nurse Practitioner

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 18963 CA Primary

Addresses

NPPES NPI Registry

Primary practice location

125 E Barstow Ave
Suite 126
Fresno, CA 93710

Mailing address

125 E Barstow Ave
Suite 126
Fresno, CA 93710
Phone (559) 222-5663

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
18963OtherSTATE LICENSE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 10, 2007.

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186704000000",
    "number": "1205028552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E BARSTOW AVE",
            "address_2": "SUITE 126",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93710",
            "telephone_number": "559-222-5663",
            "fax_number": "559-222-9235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E BARSTOW AVE",
            "address_2": "SUITE 126",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93710",
            "telephone_number": "559-222-5663",
            "fax_number": "559-222-9235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIRD",
        "first_name": "JOHN",
        "middle_name": "KENTON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-10",
        "last_updated": "2007-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "18963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "18963",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.