Provider Demographics
NPI:1629286588
Name:BAER, KIMBERLY ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:ANN
Last Name:BAER
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 1:5809 NICHOLSON LN
Mailing Address - Street 2:STE T 123
Mailing Address - City:N BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20852-5701
Mailing Address - Country:US
Mailing Address - Phone:301-770-2270
Mailing Address - Fax:301-770-2246
Practice Address - Street 1:5809 NICHOLSON LN
Practice Address - Street 2:STE T 123
Practice Address - City:N BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20852-5701
Practice Address - Country:US
Practice Address - Phone:301-770-2270
Practice Address - Fax:301-770-2246
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD126631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice