MEDICARE: TWIN OAKS DENTAL 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

General Provider Information

NPI Number	:	1619859972
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TWIN OAKS DENTAL LLC

Provider Business Mailing Address
First Line	:	118007 BETTY DR
Second Line	:
City	:	STRATFORD
State	:	WI
Zip	:	54484-8026
Country	:	US
Telephone Number	:	515-508-1050
Fax Number	:	515-508-1050

Provider Business Practice Location Address
First Line	:	6301 N OAK TRFY STE 201
Second Line	:
City	:	GLADSTONE
State	:	MO
Zip	:	64118-4752
Country	:	US
Telephone Number	:	816-413-8282
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DENTIST
Name	:	DR. JACOB CRAIG BAUMGARTNER
Credential	:	DDS
Telephone Number	:	515-508-1050

Provider Enumeration Date	:	07/25/2025
Last Update Date	:	08/13/2025

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Directions to “TWIN OAKS DENTAL LLC ” Practice Location

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