Individual provider Active NPI

Christine M Baker, DDS

  • Dentist
  • Woodbridge, VA
National Provider Identifier
1518272962
Registry record updated Mar 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
04701415394 Issued in VA
Practice address
4379 Ridgewood Center Dr Ste 102
Woodbridge, VA 22192-8323
Phone
(703) 680-7950
Fax
(703) 680-7953
NPI assigned
Aug 10, 2010
Last updated
Mar 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 04701415394 VA Primary
Dentist 122300000X 2901020077 MI

Addresses

Primary practice location

4379 Ridgewood Center Dr Ste 102
Woodbridge, VA 22192-8323

Mailing address

4379 Ridgewood Center Dr Ste 102
Woodbridge, VA 22192-8323
Phone (703) 680-7950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20170916000378 VA Order and Referring Only - DentistPractitioner - Dentist 4587938444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901020077MIMDDentist
04701415394VAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1281398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521504000000",
    "number": "1518272962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4379 RIDGEWOOD CENTER DR STE 102",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221928323",
            "telephone_number": "703-680-7950",
            "fax_number": "703-680-7953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4379 RIDGEWOOD CENTER DR STE 102",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221928323",
            "telephone_number": "703-680-7950",
            "fax_number": "703-680-7953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "CHRISTINE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-10",
        "last_updated": "2018-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "04701415394",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020077",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.