Active NPI
Karmen Bakaen
- Dentist
- Santa Ana, CA
National Provider Identifier
1417015777
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 46360
- Practice address
- 1710 E 17TH St Ste E
Santa Ana, CA 92705-8622 - Phone
- (714) 564-9000
- Fax
- (714) 564-9024
- NPI assigned
- Dec 5, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 46360 | CA | Primary |
Addresses
Primary practice location
1710 E 17TH St Ste E
Santa Ana, CA 92705-8622
Mailing address
1710 E 17TH St Ste E
Santa Ana, CA 92705-8622
Phone (714) 564-9000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| B46360-01 | Other | CA | MEDICAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160510001882 | CA | Order and Referring Only - Dentist | 5698064947 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46360 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bakaen, Karmen J, DDS a Prof Corp. | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Dental Clinic/Center
- Santa Ana, CA
- NPI 1962692012
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185235200000",
"number": "1417015777",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1710 E 17TH ST STE E",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927058622",
"telephone_number": "714-564-9000",
"fax_number": "714-564-9024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1710 E 17TH ST STE E",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927058622",
"telephone_number": "714-564-9000",
"fax_number": "714-564-9024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAKAEN",
"first_name": "KARMEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-05",
"last_updated": "2007-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "46360",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL",
"identifier": "B46360-01",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.