Individual provider Active NPI

Lorelle Layden Baum, DENTAL ASSISTANT

  • Dental Assistant
  • Elizabeth City, NC
National Provider Identifier
1457835647
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AssistantTaxonomy code 126800000X
Practice address
1288 Northside Rd
Elizabeth City, NC 27909-8526
Phone
(252) 457-5668
Fax
(757) 953-6439
NPI assigned
Sep 24, 2018
Last updated
Sep 24, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Assistant 126800000X NU Primary

Addresses

Primary practice location

1288 Northside Rd
Elizabeth City, NC 27909-8526

Mailing address

1288 Northside Rd
Elizabeth City, NC 27909-8526
Phone (252) 457-5668

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

NPI Registry JSON

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

{
    "created_epoch": "1537747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1457835647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1288 NORTHSIDE RD",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279098526",
            "telephone_number": "252-457-5668",
            "fax_number": "757-953-6439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1288 NORTHSIDE RD",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279098526",
            "telephone_number": "252-457-5668",
            "fax_number": "757-953-6439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUM",
        "first_name": "LORELLE",
        "middle_name": "LAYDEN",
        "name_prefix": "Ms.",
        "credential": "DENTAL ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-24",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth City, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; 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.