Kenneth Roger Baumgartner, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

34056 Issued in CA

Practice address

18175 N Highway One
Fort Bragg, CA 95437

Phone

(707) 964-0440

Fax

(707) 964-8373

NPI assigned

Sep 17, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ken Baumgartner Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Interoperability endpoints

• Direct secure messaging: ken.baumgartner.p1@direct.mccinc.nextgenshare.com

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205933926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18175 N HIGHWAY ONE",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "95437",
            "telephone_number": "707-964-0440",
            "fax_number": "707-964-8373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18175 N HIGHWAY ONE",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "95437",
            "telephone_number": "707-964-0440",
            "fax_number": "707-964-8373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUMGARTNER",
        "first_name": "KENNETH",
        "middle_name": "ROGER",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "34056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEN",
            "last_name": "BAUMGARTNER",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Gregory Baer
• M. Lee Baker, DDS
• Genevieve Marilyn Banegas, LCSW, PPSC
• Nadine R. Barlow, PHARMD
• Willow Bartholomew, PA
• Carrie Becker Fishman
• Joseph Edward Beeney, PHD
• Jack Linn Bellah, MD
• Logan Christopher Bengston, LMFT
• Zoe D Berna, MD

• General Practice Dentistry in Fort Bragg, CA
• Providers in Fort Bragg, CA by specialty
• General Practice Dentistry in California

• 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.