NPIMap

Organization Active NPI

Baker Family Dentistry, P.C.

  • Dentist
  • Bloomington, IN
National Provider Identifier
1972873925
Registry record updated Jan 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12009106 Issued in IN
Legal business name
BAKER FAMILY DENTISTRY, P.C.
Practice address
4217 E 3Rd St
Bloomington, IN 47401-5550
Phone
(812) 332-2000
NPI assigned
Jan 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2012

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

Authorized official

Name
Dr. Lisa J Baker, DDSNPI 1083724058
Title
Owner
Phone
(812) 332-2000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 12009106 IN Primary

Addresses

Primary practice location

4217 E 3Rd St
Bloomington, IN 47401-5550

Mailing address

4217 E 3Rd St
Bloomington, IN 47401-5550
Phone (812) 332-2000

National Provider Directory

National Provider Directory

Locations

4217 E 3rd St
Bloomington, IN 47401
Phone (812) 332-2000

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1326067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326067200000",
    "number": "1972873925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4217 E 3RD ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474015550",
            "telephone_number": "812-332-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4217 E 3RD ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474015550",
            "telephone_number": "812-332-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAKER FAMILY DENTISTRY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-09",
        "last_updated": "2012-01-09",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-332-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12009106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.