Douglas Stephen Baribeau, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

2901010283 Issued in MI

Practice address

1026 Superior St
Port Huron, MI 48060-3748

Phone

(810) 987-5040

Fax

(810) 987-9499

NPI assigned

May 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Pediatric Dental Specilaist, P.C

  • Pediatric Dentistry
  • Port Huron, MI
  • NPI 1255063244
  NPD

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

{
    "created_epoch": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1346299658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 SUPERIOR ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603748",
            "telephone_number": "810-987-5040",
            "fax_number": "810-987-9499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 SUPERIOR ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603748",
            "telephone_number": "810-987-5040",
            "fax_number": "810-987-9499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARIBEAU",
        "first_name": "DOUGLAS",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-06",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MI",
            "license": "2901010283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4032586",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tina Marie Bambusch
• Ahmed Banijamei, MD
• Aidan Bannon
• Cherie Bantle
• Terrance James Barden Jr., PHARMD
• Bryan Harvey Barkley, C.R.N.A.
• Michael Patrick Barna, M.D.
• Annette Barnes-Grain, M.D.
• Debra Jean Barnes
• Racheal Barnes

• Pediatric Dentistry in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Pediatric Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; 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.