Individual provider Active NPI

Dorsey W Baker, D.D.S.

  • Dentist
  • Glendale, AZ
National Provider Identifier
1376657619
Registry record updated Jun 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
AZ3760 Issued in AZ
Practice address
18275 N. 59 Ave
Ste 150
Glendale, AZ 85308
Phone
(602) 942-0623
Fax
(602) 942-2409
NPI assigned
Aug 17, 2006
Last updated
Jun 8, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X AZ3760 AZ Primary
General Practice Dentistry 1223G0001X AZ 3760 AZ
General Practice Dentistry 1223G0001X AZ3760 AZ

Addresses

Primary practice location

18275 N. 59 Ave
Ste 150
Glendale, AZ 85308

Mailing address

18275 N. 59 Ave
Ste 150
Glendale, AZ 85308
Phone (602) 942-0623

Other identifiers 1

IdentifierTypeStateIssuer
AZ3760OtherAZAZ DENTAL BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AZ3760AZMDDentist
AZ 3760AZMDGeneral Practice Dentistry

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244419200000",
    "number": "1376657619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18275 N. 59 AVE",
            "address_2": "STE 150",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85308",
            "telephone_number": "602-942-0623",
            "fax_number": "602-942-2409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18275 N. 59 AVE",
            "address_2": "STE 150",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85308",
            "telephone_number": "602-942-0623",
            "fax_number": "602-942-2409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "DORSEY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2009-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "AZ3760",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "AZ 3760",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "AZ3760",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ DENTAL BOARD",
            "identifier": "AZ3760",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.