Active NPI
Kimberly Baldwin
- Dental Therapist
- Kotzebue, AK
National Provider Identifier
1205236692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Therapist
- License
- 06-021-DHAT
- Practice address
- 436 5TH Ave Ted Stevens Way
Kotzebue, AK 99752 - Phone
- (907) 442-7325
- Fax
- (907) 442-7308
- NPI assigned
- Sep 4, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Therapist | 125J00000X | 06-021-DHAT | ZZ | Primary |
Addresses
Primary practice location
436 5TH Ave Ted Stevens Way
Kotzebue, AK 99752
Mailing address
436 5TH Ave Ted Stevens Way
Kotzebue, AK 99752
Phone (907) 442-7325
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
| License | State | Type | Specialty |
|---|---|---|---|
| 06-021-DHAT | ZZ | MD | Dental Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maniilaq Association | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community Health Worker
- Kotzebue, AK
- NPI 1801296744
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409788800000",
"number": "1205236692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "436 5TH AVE TED STEVENS WAY",
"city": "KOTZEBUE",
"state": "AK",
"postal_code": "99752",
"telephone_number": "907-442-7325",
"fax_number": "907-442-7308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "436 5TH AVE TED STEVENS WAY",
"city": "KOTZEBUE",
"state": "AK",
"postal_code": "99752",
"telephone_number": "907-442-7325",
"fax_number": "907-442-7308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALDWIN",
"first_name": "KIMBERLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-04",
"last_updated": "2014-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "125J00000X",
"taxonomy_group": "",
"desc": "Dental Therapist",
"state": "ZZ",
"license": "06-021-DHAT",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kotzebue, AK
- Alaskans Changing Together, Inc.
- Mary Grace D Anderson, MC
- Arctic Chiropractic Kotzebue, LLC
- Audrey Arey, COMMUITY HEALTH AIDE
- Gloria D Baker, LPN
- Teressa Kaye Baldwin, MSW
- Aimee Heather Ballew, APRN, FNP-BC
- Amelia J Ballot, BHA-T
- Charlotte Ballot, COMMUNITY HEALTH AID
- Karen Ballot, COMMUNITY HEALTH AID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.