Nicholas Edward Baker, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.087687 Issued in IL

Practice address

2206 E Oakland Ave
Bloomington, IL 61701-5761

Phone

(309) 662-5921

Fax

(309) 661-2159

NPI assigned

Aug 6, 2008

Sex

Male

Sole proprietor

No

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

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217980800000",
    "number": "1861658015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2206 E OAKLAND AVE",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617015761",
            "telephone_number": "309-662-5921",
            "fax_number": "309-661-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2206 E OAKLAND AVE",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617015761",
            "telephone_number": "309-662-5921",
            "fax_number": "309-661-2159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "NICHOLAS",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-06",
        "last_updated": "2008-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.087687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Bain
• Deanne Lois Drechsler Bajaj, LCSW
• Krista Elisabeth Bajjalieh, OTR/L
• Kaylie Bakalar
• Chelsey Baker
• Zoe Jane Baker, LCSW
• Prithvi Balaji
• Kim Marie Baldwin, PSYD
• Mi H Balgemann, DNP, CRNA
• Catherine L Ballard, RN

• General Practice Dentistry in Bloomington, IL
• Providers in Bloomington, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.