Provider Demographics
NPI:1043992555
Name:BAKER, ALLISON ELAINE (DH)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:ELAINE
Last Name:BAKER
Suffix:
Gender:F
Credentials:DH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 N BRASS AVE
Mailing Address - Street 2:
Mailing Address - City:JUNIATA
Mailing Address - State:NE
Mailing Address - Zip Code:68955-2215
Mailing Address - Country:US
Mailing Address - Phone:402-874-1096
Mailing Address - Fax:
Practice Address - Street 1:516 W 11TH ST STE 108B
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-7310
Practice Address - Country:US
Practice Address - Phone:308-233-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3197124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist