Kimberley Anne Baker, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19129 Issued in TX

Practice address

1405 Cannon Pkwy
Roanoke, TX 76262-3620

Phone

(817) 430-1212

Fax

(817) 491-0154

NPI assigned

Jul 12, 2012

Last updated

Jul 12, 2012By the provider in NPPES

Sex

Female

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

Medicare enrollment (NPD)

Not 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.

• Kimberley a Baker, DDS, PA

  dba Roanoke Family Dentistry

  • General Practice Dentistry
  • Roanoke, TX
  • NPI 1750314761
  NPD (past) Authorized official
• Kelly Harrelson DDS, PLLC

  dba Harrelson Family Dentistry

  • Dental Clinic/Center
  • Roanoke, TX
  • NPI 1205650264
  NPD (past)

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

{
    "created_epoch": "1342051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342051200000",
    "number": "1689939845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 CANNON PKWY",
            "city": "ROANOKE",
            "state": "TX",
            "postal_code": "762623620",
            "telephone_number": "817-430-1212",
            "fax_number": "817-491-0154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 CANNON PKWY",
            "city": "ROANOKE",
            "state": "TX",
            "postal_code": "762623620",
            "telephone_number": "817-430-1212",
            "fax_number": "817-491-0154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "KIMBERLEY",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-12",
        "last_updated": "2012-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "19129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antolin-Sanchez Dental Group PLLC
• Rhea Theresa Coronel Antolin, D.M.D.
• Roddrick Keith Armwood
• Amanda Kay Attaway
• Babies and Bellies Family Chiropractic PLLC (Alignform Chiropractic)
• Adia Banks, LCSW
• Be Good Healthcare Inc (A Good HomeHealth)
• Taylor Jo Beaulieu, DPT
• Jenna Denise Beck, D.C., B.S.
• John Belew

• General Practice Dentistry in Roanoke, TX
• Providers in Roanoke, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2012; 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.