Kenneth J. Baldwin, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

144670-9924 Issued in UT

Practice address

4046 Highland Dr
Suite #112
Salt Lake City, UT 84124-1673

Phone

(801) 273-5600

Fax

(801) 273-5678

NPI assigned

Oct 20, 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 Jul 6, 2015 through Jul 6, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Ut Oms Specialty Dental Services PLLC

  dba Utah Orthofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Salt Lake City, UT
  • NPI 1407613342
  NPD (past)

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669554119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4046 HIGHLAND DR",
            "address_2": "SUITE #112",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241673",
            "telephone_number": "801-273-5600",
            "fax_number": "801-273-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4046 HIGHLAND DR",
            "address_2": "SUITE #112",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241673",
            "telephone_number": "801-273-5600",
            "fax_number": "801-273-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDWIN",
        "first_name": "KENNETH",
        "middle_name": "J.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "144670-9924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriella Maria Balderrama
• Erin Baldwin, M.S.
• Ernest F Baldwin III, MD
• Florenda Baldwin
• George Nicholas Baldwin, M.D.
• Kyle J Baldwin, DDS
• Robert Thomas Baldwin
• Shaylyn Annette Baldwin
• Vicki Lynne Baldwin, LPC
• James Franklin Bale Jr., M.D.

• Oral and Maxillofacial Surgery (Dentist) in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Utah

• 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.