Active NPI
Tamara Baca, RDH MPH
- Dental Hygienist
- Phoenix, AZ
National Provider Identifier
1689125122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- H04531
- Practice address
- 635 E Baseline Rd
Phoenix, AZ 85042-6551 - Phone
- (602) 243-7277
- NPI assigned
- Oct 19, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | H04531 | AZ | Primary |
Addresses
Primary practice location
635 E Baseline Rd
Phoenix, AZ 85042-6551
Mailing address
714 E Taylor St
Tempe, AZ 85281-1158
Phone (602) 818-8778
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H04531 | AZ | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481587200000",
"number": "1689125122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "714 E TAYLOR ST",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852811158",
"telephone_number": "602-818-8778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "635 E BASELINE RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850426551",
"telephone_number": "602-243-7277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACA",
"first_name": "TAMARA",
"credential": "RDH MPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-19",
"last_updated": "2016-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "AZ",
"license": "H04531",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.