Li Bao, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DD4029 Issued in NM

Practice address

475 Coors Blvd NW Ste a
Albuquerque, NM 87121-1426

Phone

(505) 208-0505

NPI assigned

Jan 7, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

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

Specialty

Oral Surgery

Education

Boston Univ Goldman School of Dental Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• A Better Smile Dentistry LLC

  • Dentist
  • Albuquerque, NM
  • NPI 1750820619
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1389052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1730501032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 COORS BLVD NW STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871211426",
            "telephone_number": "505-208-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 COORS BLVD NW STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871211426",
            "telephone_number": "505-208-0505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4111 Barbara Loop SE Ste E2",
            "address_purpose": "LOCATION",
            "city": "Rio Rancho",
            "state": "NM",
            "postal_code": "871241068",
            "country_code": "US",
            "telephone_number": "505-208-0505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAO",
        "first_name": "LI",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-07",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63209",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD4029",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD4029",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NM",
            "license": "DD4029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lane Bannwart, MD
• Jennifer Bannwarth, RN
• Franchesca Banuelos, MA LPCC
• Valerie Banuelos, MS, BCBA
• Brenna Banwarth-Kuhn
• Diane Baptista, FNPC
• Susan Elizabeth Bapty, LMHC
• Dominica S Barabe, DPT
• Erin Baragiola, FNP
• Dunia Barahona

• Oral and Maxillofacial Surgery (Dentist) in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Oral and Maxillofacial Surgery (Dentist) in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.