Individual provider Active NPI

Andrew William Baker, D.D.S.

  • Periodontics
  • West Chester, OH
National Provider Identifier
1265768089
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
30-023024 Issued in OH
Practice address
7665 Monarch CT
West Chester, OH 45069
Phone
(513) 563-6611
Fax
(513) 563-4107
NPI assigned
Oct 29, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 30-023024 OH Primary

Addresses

Primary practice location

7665 Monarch CT
West Chester, OH 45069

Mailing address

5562 Squires Gate Dr
Mason, OH 45040
Phone (419) 260-6019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160425000450 OH Order and Referring Only - Other (Non-Physician) 6103125216

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30-023024OHMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Lipson DDS Inc Periodontics Current 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.

NPI Registry JSON

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

{
    "created_epoch": "1256774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1265768089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5562 SQUIRES GATE DR",
            "city": "MASON",
            "state": "OH",
            "postal_code": "45040",
            "telephone_number": "419-260-6019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7665 MONARCH CT",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "45069",
            "telephone_number": "513-563-6611",
            "fax_number": "513-563-4107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "ANDREW",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-29",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OH",
            "license": "30-023024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, OH

Sources for this page

Verify at the official NPI Registry.