Ksenia G. Baxter, DMD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

10812 Issued in CT

Practice address

2 Stony Hill Rd
Bethel, CT 06801

Phone

(203) 792-2263

NPI assigned

Jun 30, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527033600000",
    "number": "1467749283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 STONY HILL RD",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "068011063",
            "telephone_number": "203-792-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 STONY HILL RD",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "06801",
            "telephone_number": "203-792-2263"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "263 Farmington Ave",
            "address_2": "UConn School of Dental Medicine",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060303905",
            "country_code": "US",
            "telephone_number": "860-679-2207",
            "fax_number": "860-679-1899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAXTER",
        "first_name": "KSENIA",
        "middle_name": "G.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-30",
        "last_updated": "2018-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "10812",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CT",
            "license": "10812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004011136",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Bachman, LPC
• Susan Backman, MT, CMLDT
• Baker Pharmacy LTD (English Drug Company)
• Barbara Kelly, LPC
• Beth Batchler, MS OTR/L
• Austin Arthur Bebyn
• Becoming Her Psychotherapy PLLC
• Carol Lynn Berran, LMFT
• Bethel Chiropractic and Sports Therapy, LLC
• Bethel Health and Rehabilitation Center LLC

• Periodontics in Bethel, CT
• Providers in Bethel, CT by specialty
• Periodontics in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2018; 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.

Verify at the official NPI Registry.