MEDICARE: MARIE BAUMGARTNER DDS LLC

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	1223G0001X	General Practice Dentistry

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	500607846	OTHER	OR	DMAD

General Provider Information

NPI Number	:	1598615932
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARIE BAUMGARTNER DDS LLC

Provider Business Mailing Address
First Line	:	5885 SHOREVIEW LN N.
Second Line	:
City	:	KEIZER
State	:	OR
Zip	:	97303
Country	:	US
Telephone Number	:	503-393-5133
Fax Number	:	503-400-4236

Provider Business Practice Location Address
First Line	:	5885 SHOREVIEW LN N.
Second Line	:
City	:	KEIZER
State	:	OR
Zip	:	97303
Country	:	US
Telephone Number	:	503-393-5133
Fax Number	:	503-400-4236

Authorized Official
Title or Position	:	DENTIST /PRACTICE OWNER
Name	:	MARIE BAUMGARTNER
Credential	:	DDS
Telephone Number	:	503-393-5133

Provider Enumeration Date	:	02/03/2026
Last Update Date	:	02/03/2026

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