Healthcare Provider Details

I. General information

NPI: 1770574287
Provider Name (Legal Business Name): JAMES A BAKER I DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8301 S WALKER AVE STE 101
OKLAHOMA CITY OK
73139-9416
US

IV. Provider business mailing address

PO BOX 108811
OKLAHOMA CITY OK
73101-8811
US

V. Phone/Fax

Practice location:
  • Phone: 405-636-4230
  • Fax: 405-634-7994
Mailing address:
  • Phone: 405-848-7974
  • Fax: 405-848-0033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number3900
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: