MEDICARE: VIVI BALDWIN 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	1223G0001X	General Practice Dentistry	7270	NV

General Provider Information

NPI Number	:	1831739150
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIVI BALDWIN DMD

Provider Business Mailing Address
First Line	:	2010 LORO CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1855
Country	:	US
Telephone Number	:	702-580-1320
Fax Number	:

Provider Business Practice Location Address
First Line	:	7785 N DURANGO DR STE 140
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-8002
Country	:	US
Telephone Number	:	702-987-8668
Fax Number	:

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

Provider Enumeration Date	:	01/15/2020
Last Update Date	:	01/15/2020

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