Provider Demographics
NPI:1508398272
Name:BAKER, JAMES (DMD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:BAKER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 RIVERPATH DR APT 10
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-3992
Mailing Address - Country:US
Mailing Address - Phone:203-940-3897
Mailing Address - Fax:
Practice Address - Street 1:110 KIMBALL AVE STE 210
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-6841
Practice Address - Country:US
Practice Address - Phone:802-491-4400
Practice Address - Fax:802-491-4401
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-31
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1857904122300000X
VT016.01338831223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist