Baseline Road Dental LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

BASELINE ROAD DENTAL LLC

Practice address

3130 E Baseline Rd 105/106
Mesa, AZ 85204

Phone

(480) 701-6656

Fax

(480) 452-1614

NPI assigned

May 22, 2024

Organization subpart

No

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

Authorized official

Name

Jenny Garcia Rocha

Title

Sr Team Lead

Phone

(972) 869-3789

Specialties & licenses 1

Addresses

Other names 1

• Desert Dental Specialists Doing business as

Locations

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

{
    "created_epoch": "1716336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716336000000",
    "number": "1366281149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 E BASELINE RD 105/106",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85204",
            "telephone_number": "480-701-6656",
            "fax_number": "480-452-1614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 E BASELINE RD 105/106",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85204",
            "telephone_number": "480-701-6656",
            "fax_number": "480-452-1614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BASELINE ROAD DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-22",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A",
        "authorized_official_last_name": "GARCIA ROCHA",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "SR TEAM LEAD",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Desert Dental Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bonnie Jean Bartol, MA NCSP
• Alice Joy Barton, LPC
• Tyler Barton, PHARMD
• Diane Theresa Bartsch, M.S.
• Baseline Pain Center, LLC
• Jessica Basha, DPT
• Sheila R Basler Powell, OTR/L
• Jennifer Jay Bass, LM, CPM
• Mathew J Bassett, BHT
• Adam T. Bast, MA, CCC-SLP

• Oral and Maxillofacial Surgery (Dentist) in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Oral and Maxillofacial Surgery (Dentist) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; 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.