Pontip Baillie, DDS, MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

6469 Issued in AZ

Practice address

1050 N San Francisco St
Suite B
Flagstaff, AZ 86001-3259

Phone

(928) 779-3644

Fax

(928) 773-9872

NPI assigned

Jul 9, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346273752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 N SAN FRANCISCO ST",
            "address_2": "SUITE B",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013259",
            "telephone_number": "928-779-3644",
            "fax_number": "928-773-9872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 N SAN FRANCISCO ST",
            "address_2": "SUITE B",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013259",
            "telephone_number": "928-779-3644",
            "fax_number": "928-773-9872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILLIE",
        "first_name": "PONTIP",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "AZ",
            "license": "6469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Kay Badour
• Douglas E. Baer Sr., RPH
• Paula D Baglioni, M.D.
• Sandy D Bailey, RN
• Kyrke Brandon Baillie, DDS
• Gayle Marie Baingo, R.D.N
• Brittany Baird, SLPA
• Jonathan Baker, DDS
• Balance Health and Wellness
• Balance Mental Health and Wellness LLC.

• Periodontics in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Periodontics in Arizona

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.