Healthcare Provider Details

I. General information

NPI: 1386962629
Provider Name (Legal Business Name): RYAN WILLIAM BAKER D.M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2010
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 E 42ND AVE STE 104
ANCHORAGE AK
99508-5228
US

IV. Provider business mailing address

2401 E 42ND AVE STE 104
ANCHORAGE AK
99508-5228
US

V. Phone/Fax

Practice location:
  • Phone: 907-561-0675
  • Fax: 907-562-1563
Mailing address:
  • Phone: 907-561-0675
  • Fax: 907-562-1563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number8913
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number28873
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number105009
License Number StateAK
# 4
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberD008809
License Number StateAZ
# 5
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: