Active NPI
Brooke Marie Baker, D.D.S.
- General Practice Dentistry
- Fargo, ND
National Provider Identifier
1366450587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 1988
- Practice address
- 1790 32ND Ave S
Fargo, ND 58103-5942 - Phone
- (701) 232-0774
- Fax
- (701) 232-1158
- NPI assigned
- Aug 3, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1988 | ND | Primary |
Addresses
Primary practice location
1790 32ND Ave S
Fargo, ND 58103-5942
Mailing address
10212 Ida Oaks Rd
Pelican Rapids, MN 56572-9317
Phone (218) 532-2697
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1988 | ND | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444003200000",
"number": "1366450587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10212 IDA OAKS RD",
"city": "PELICAN RAPIDS",
"state": "MN",
"postal_code": "565729317",
"telephone_number": "218-532-2697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1790 32ND AVE S",
"city": "FARGO",
"state": "ND",
"postal_code": "581035942",
"telephone_number": "701-232-0774",
"fax_number": "701-232-1158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAKER",
"first_name": "BROOKE",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-03",
"last_updated": "2015-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "ND",
"license": "1988",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.