Provider Demographics
NPI:1265768089
Name:BAKER, ANDREW WILLIAM (DDS)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:WILLIAM
Last Name:BAKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5562 SQUIRES GATE DR
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040
Mailing Address - Country:US
Mailing Address - Phone:419-260-6019
Mailing Address - Fax:
Practice Address - Street 1:7665 MONARCH CT
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069
Practice Address - Country:US
Practice Address - Phone:513-563-6611
Practice Address - Fax:513-563-4107
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-29
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0230241223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics