Organization Active NPI

Ignacio Alberto Baez DMD PA

  • Dental Clinic/Center
  • Orlando, FL
National Provider Identifier
1306290523
Registry record updated Apr 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DN0007199 Issued in FL
Legal business name
IGNACIO ALBERTO BAEZ DMD PA
Practice address
300 Gatlin Ave
Orlando, FL 32806-6951
Phone
(407) 310-6627
NPI assigned
Apr 14, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2016

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

Authorized official

Name
Dr. Ignacio Alberto Baez
Title
Owner
Phone
(407) 310-6627

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DN0007199 FL Primary

Addresses

Primary practice location

300 Gatlin Ave
Orlando, FL 32806-6951

Mailing address

300 Gatlin Ave
Orlando, FL 32806-6951
Phone (407) 310-6627

Other identifiers 2

IdentifierTypeStateIssuer
002854600MedicaidFL
075096496OtherFLMED WAIVER

National Provider Directory

National Provider Directory

Locations

300 Gatlin Ave
Orlando, FL 32806
Phone (407) 857-4244

NPI Registry JSON

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

{
    "created_epoch": "1460592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460592000000",
    "number": "1306290523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 GATLIN AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328066951",
            "telephone_number": "407-310-6627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 GATLIN AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328066951",
            "telephone_number": "407-310-6627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IGNACIO ALBERTO BAEZ DMD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-14",
        "last_updated": "2016-04-14",
        "status": "A",
        "authorized_official_last_name": "BAEZ",
        "authorized_official_first_name": "IGNACIO",
        "authorized_official_middle_name": "ALBERTO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-310-6627",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "DN0007199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002854600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED WAIVER",
            "identifier": "075096496",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2016; 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.