Provider Demographics
NPI:1427566223
Name:BALDWIN DENTISTRY PA
Entity Type:Organization
Organization Name:BALDWIN DENTISTRY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:BALDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:561-996-0033
Mailing Address - Street 1:135 US HIGHWAY 27 S
Mailing Address - Street 2:
Mailing Address - City:SOUTH BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33493-2213
Mailing Address - Country:US
Mailing Address - Phone:561-996-0033
Mailing Address - Fax:561-996-0044
Practice Address - Street 1:135 US HIGHWAY 27 S
Practice Address - Street 2:
Practice Address - City:SOUTH BAY
Practice Address - State:FL
Practice Address - Zip Code:33493-2213
Practice Address - Country:US
Practice Address - Phone:561-996-0033
Practice Address - Fax:561-996-0044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-15
Last Update Date:2018-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN21975122300000X, 261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018929800Medicaid