Organization Active NPI

Dr Carolyn R Baldiviez Dental Corporation

  • General Practice Dentistry
  • Santa Maria, CA
National Provider Identifier
1639016959
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DR CAROLYN R BALDIVIEZ DENTAL CORPORATION
Practice address
111 E Park Ave
Santa Maria, CA 93454-6625
Phone
(805) 925-8112
NPI assigned
May 4, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2026

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

Authorized official

Name
Dr. Carolyn R Baldiviez, DDSNPI 1225069172
Title
President
Phone
(805) 925-8112

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

111 E Park Ave
Santa Maria, CA 93454-6625

Mailing address

111 E Park Ave
Santa Maria, CA 93454-6625
Phone (805) 925-8112

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1777852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777852800000",
    "number": "1639016959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E PARK AVE",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934546625",
            "telephone_number": "805-925-8112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E PARK AVE",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934546625",
            "telephone_number": "805-925-8112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR CAROLYN R BALDIVIEZ DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-04",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A",
        "authorized_official_last_name": "BALDIVIEZ",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-925-8112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; 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.