MEDICARE: ABIGAIL CASTLE BALDWIN JOHN DMD

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	1223E0200X	Endodontics	064738	NY

General Provider Information

NPI Number	:	1053295899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL CASTLE BALDWIN JOHN DMD

Provider Business Mailing Address
First Line	:	69 ATWOOD DR
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14606-4564
Country	:	US
Telephone Number	:	360-710-5124
Fax Number	:

Provider Business Practice Location Address
First Line	:	6800 PITTSFORD PALMYRA RD STE 110
Second Line	:
City	:	FAIRPORT
State	:	NY
Zip	:	14450-3514
Country	:	US
Telephone Number	:	585-223-5330
Fax Number	:

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

Provider Enumeration Date	:	08/04/2025
Last Update Date	:	03/28/2026

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