Wilson Boyd Baugh Jr, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

029556 Issued in CA

Practice address

1897 N Waterman Ave
San Bernardino, CA 92404-4830

Phone

(909) 882-3371

Fax

(909) 882-1493

NPI assigned

Dec 27, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 20, 2016 through Jan 20, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548326572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1897 N WATERMAN AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044830",
            "telephone_number": "909-882-3371",
            "fax_number": "909-882-1493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1897 N WATERMAN AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044830",
            "telephone_number": "909-882-3371",
            "fax_number": "909-882-1493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUGH JR",
        "first_name": "WILSON",
        "middle_name": "BOYD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "029556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Bathan
• Leon Bathini Jr., MD
• Whitney R Batson
• Rae Justine Franco Battung
• Gabrielle Annali Bauer
• Jessica Bautista de Mora
• Karina Bautista-Moreno
• Allison Kathleen Bautista, ASW
• Corbin Baxter, MSW, ASW
• Bayada Home Health Care, Inc.

• Oral and Maxillofacial Surgery (Dentist) in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.