Provider Demographics
NPI:1811125222
Name:BAXTER, BARBARA ELLEN (DMD)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:ELLEN
Last Name:BAXTER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:ELLEN
Other - Last Name:BAXTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:1234 19TH ST NW
Mailing Address - Street 2:704
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-2407
Mailing Address - Country:US
Mailing Address - Phone:202-296-3330
Mailing Address - Fax:202-467-4427
Practice Address - Street 1:1234 19TH ST NW
Practice Address - Street 2:704
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-2407
Practice Address - Country:US
Practice Address - Phone:202-296-3330
Practice Address - Fax:202-467-4427
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-24
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN4827122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist