Provider Demographics
NPI:1801816970
Name:BAKER, JOE (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOE
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 1:31655 COAST HWY
Mailing Address - Street 2:
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-6979
Mailing Address - Country:US
Mailing Address - Phone:949-499-8155
Mailing Address - Fax:949-499-8157
Practice Address - Street 1:31655 COAST HWY
Practice Address - Street 2:
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-6979
Practice Address - Country:US
Practice Address - Phone:949-499-8155
Practice Address - Fax:949-499-8157
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA285131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice