Individual provider Active NPI

Suzanne Davis Baker, DDS, MPH

  • Dentist
  • Raleigh, NC
National Provider Identifier
1851788053
Registry record updated Jul 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10053 Issued in NC
Practice address
510 Glenwood Ave
Suite 110
Raleigh, NC 27603
Phone
(919) 570-0180
Fax
(919) 570-0280
NPI assigned
Apr 25, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10053 NC Primary

Addresses

Primary practice location

510 Glenwood Ave
Suite 110
Raleigh, NC 27603

Mailing address

2800 Wakefield Pines Drive
Suite 110
Raleigh, NC 27614
Phone (919) 570-0180

Other practice location 1

170 Manning Dr
Chapel Hill, NC 27514-4221
Phone (229) 894-5896

Other names 1

  • Suzanne Louise Davis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150514002952 NC Order and Referring Only - Other (Non-Physician) 5193045144

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10053NCMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Johnson & Morris PLLC CurrentSince Oct 1, 2023 Accepting new patients
Dr. Cameron & Associates of Raleigh I, PLLC CurrentSince Jul 28, 2019 Accepting new patients
Unc School of Dentistry Dentist Past Accepting new patients

Locations

2800 Wakefield Pines Dr
Ste 110
Raleigh, NC 27614
Phone (919) 570-0180

510 Glenwood Ave
Ste 110
Raleigh, NC 27603
Phone (919) 570-0180

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1429920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1851788053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 WAKEFIELD PINES DRIVE",
            "address_2": "SUITE 110",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27614",
            "telephone_number": "919-570-0180",
            "fax_number": "919-570-0280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 GLENWOOD AVE",
            "address_2": "SUITE 110",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27603",
            "telephone_number": "919-570-0180",
            "fax_number": "919-570-0280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "170 Manning Dr",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275144221",
            "country_code": "US",
            "telephone_number": "229-894-5896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAKER",
        "first_name": "SUZANNE",
        "middle_name": "DAVIS",
        "credential": "DDS, MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-25",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "10053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUZANNE",
            "last_name": "DAVIS",
            "middle_name": "LOUISE",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.