NPIMap

Organization Active NPI

Elvis Baquero DDS, Inc.

  • General Practice Dentistry
  • Nipton, CA
National Provider Identifier
1306181037
Registry record updated Dec 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
49059 Issued in CA
Legal business name
ELVIS BAQUERO DDS, INC.
Practice address
100826 Nipton Rd
Nipton, CA 92364
Phone
(760) 856-1056
Fax
(760) 856-1050
NPI assigned
Dec 6, 2012
Last updated
Dec 6, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2012

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

Authorized official

Name
Dr. Elvis Baquero, DDS
Title
President
Phone
(760) 856-1056

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 49059 CA Primary

Addresses

Primary practice location

100826 Nipton Rd
Nipton, CA 92364

Mailing address

HC 1 Box 300
Nipton, CA 92364-9735
Phone (760) 856-1056

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1354752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354752000000",
    "number": "1306181037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 1 BOX 300",
            "city": "NIPTON",
            "state": "CA",
            "postal_code": "923649735",
            "telephone_number": "760-856-1056",
            "fax_number": "760-856-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100826 NIPTON RD",
            "city": "NIPTON",
            "state": "CA",
            "postal_code": "92364",
            "telephone_number": "760-856-1056",
            "fax_number": "760-856-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELVIS BAQUERO DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-06",
        "last_updated": "2012-12-06",
        "status": "A",
        "authorized_official_last_name": "BAQUERO",
        "authorized_official_first_name": "ELVIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-856-1056",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "49059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2012; 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.