Individual provider Active NPI

Rhett Austin Baynes

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1629685185
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
107676 Issued in CA
Practice address
3268 Greyling Dr
San Diego, CA 92123-2230
Phone
(760) 828-8250
NPI assigned
Sep 29, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 107676 CA Primary
General Practice Dentistry 1223G0001X D-5209 ID

Addresses

Primary practice location

3268 Greyling Dr
San Diego, CA 92123-2230

Mailing address

3268 Greyling Dr
San Diego, CA 92123-2230
Phone (760) 828-8250

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250812002386 CA Order and Referring Only - DentistPractitioner - Dentist 9436657137

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D-5209IDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Yes Today Dentistry Lewiston PLLC General Practice PastSince May 9, 2021 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1601337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1629685185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3268 GREYLING DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232230",
            "telephone_number": "760-828-8250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3268 GREYLING DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232230",
            "telephone_number": "760-828-8250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYNES",
        "first_name": "RHETT",
        "middle_name": "AUSTIN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-29",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "107676",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-5209",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.