MEDICARE: DR. JOHN ANTHONY BAKER DDS, MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	2901602414	MI

General Provider Information

NPI Number	:	1023831039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN ANTHONY BAKER DDS, MS

Provider Business Mailing Address
First Line	:	23851 FORD RD
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48128-1287
Country	:	US
Telephone Number	:	631-566-4542
Fax Number	:

Provider Business Practice Location Address
First Line	:	23851 FORD RD
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48128-1287
Country	:	US
Telephone Number	:	313-274-4800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2024
Last Update Date	:	03/26/2025

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