1871660282 NPI number — MR. STEVEN BAXTER MEANS DDS

Table of content: MR. STEVEN BAXTER MEANS DDS (NPI 1871660282)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871660282 NPI number — MR. STEVEN BAXTER MEANS DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MEANS
Provider First Name:
STEVEN
Provider Middle Name:
BAXTER
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871660282
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/27/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
322 DENTAL SCIENCE BLDG S
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
IOWA CITY
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52242-1001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
319-335-7440
Provider Business Mailing Address Fax Number:
319-335-7451

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2221 UNIVERSITY AVE SE
Provider Second Line Business Practice Location Address:
SUITE 119
Provider Business Practice Location Address City Name:
MPLS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55414
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-378-1909
Provider Business Practice Location Address Fax Number:
612-378-1909
Provider Enumeration Date:
11/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  8508 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 533018100 . This is a "MEDICAL ASSISTANCE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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