DR. MARK ENSIO BAKER D.D.S. NPI 1184798811

NPI Information

NPI: 1184798811
Provider Name: DR. MARK ENSIO BAKER, D.D.S.
Classification: Dentist - 1223S0112X
Entity Type: Individual

Specialization: Oral and Maxillofacial Surgery

PECOS Registration: Yes

Address:
165 N 14TH AVE
POCATELLO, ID
ZIP 83201
Phone: (208) 232-2807
Get Directions

DR. Mark Ensio Baker, D.D.S. is an oral and maxillofacial surgery dentist in Pocatello, ID. The provider is the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. DR. Mark Ensio Baker, D.D.S. NPI is 1184798811. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

165 N 14TH AVE
POCATELLO, ID
ZIP 83201-146
Phone: (208) 232-2807
Fax: (208) 232-8118

The NPI 1184798811 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 11/17/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223S0112X	Dentist	Oral and Maxillofacial Surgery	D3016	IDAHO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	U32580	MEDICARE UPIN	IDAHO
2	1204023	MEDICARE ID-TYPE UNSPECIFIED	IDAHO
3	000010010306	OTHER	IDAHO	RAILROAD
4	60806	OTHER	IDAHO	BLUE CROSS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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