Individual provider Active NPI

Christopher Throan Bakke, D.M.D.

  • General Practice Dentistry
  • Marietta, GA
National Provider Identifier
1780866566
Registry record updated Dec 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10661 Issued in GA
Practice address
1735 Roswell Rd
Building #200
Marietta, GA 30062-3940
Phone
(770) 973-4214
NPI assigned
Dec 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 10661 GA Primary

Addresses

Primary practice location

1735 Roswell Rd
Building #200
Marietta, GA 30062-3940

Mailing address

1735 Roswell Rd
Building #200
Marietta, GA 30062-3940

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

LicenseStateTypeSpecialty
10661GAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196640000000",
    "number": "1780866566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 ROSWELL RD",
            "address_2": "BUILDING #200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300623940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1735 ROSWELL RD",
            "address_2": "BUILDING #200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300623940",
            "telephone_number": "770-973-4214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKKE",
        "first_name": "CHRISTOPHER",
        "middle_name": "THROAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-03",
        "last_updated": "2007-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "10661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; 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.