Active NPI
Thomas Baker, D.M.D
- Pediatric Dentistry
- Idaho Falls, ID
National Provider Identifier
1376969360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- D4732PD
- Practice address
- 1900 John Adams Pkwy
Idaho Falls, ID 83401-4366 - Phone
- (208) 524-0644
- Fax
- (208) 524-6100
- NPI assigned
- Mar 14, 2014
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | D4732PD | ID | Primary |
Addresses
Primary practice location
1900 John Adams Pkwy
Idaho Falls, ID 83401-4366
Mailing address
3586 Daleen St
Ammon, ID 83401-4642
Phone (208) 589-1870
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 |
|---|---|---|---|
| D4732PD | ID | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1394755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473638400000",
"number": "1376969360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3586 DALEEN ST",
"city": "AMMON",
"state": "ID",
"postal_code": "834014642",
"telephone_number": "208-589-1870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 JOHN ADAMS PKWY",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834014366",
"telephone_number": "208-524-0644",
"fax_number": "208-524-6100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAKER",
"first_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-03-14",
"last_updated": "2016-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "ID",
"license": "D4732PD",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Idaho Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.