Provider Demographics
NPI:1073720850
Name:BAKER, TANIA MARIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:TANIA
Middle Name:MARIA
Last Name:BAKER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4937 LAS VIRGENES RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-2949
Mailing Address - Country:US
Mailing Address - Phone:818-880-5520
Mailing Address - Fax:818-880-5355
Practice Address - Street 1:4937 LAS VIRGENES RD
Practice Address - Street 2:SUITE 203
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-2949
Practice Address - Country:US
Practice Address - Phone:818-880-5520
Practice Address - Fax:818-880-5355
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38643122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist