Provider Demographics
NPI:1568611978
Name:SINGH-BAKER, SUMITA CHAKRABORTI (DDS)
Entity type:Individual
Prefix:DR
First Name:SUMITA
Middle Name:CHAKRABORTI
Last Name:SINGH-BAKER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3907 JOHN SIMPSON TRL
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78732-2265
Mailing Address - Country:US
Mailing Address - Phone:512-619-3514
Mailing Address - Fax:
Practice Address - Street 1:1213 RANCH ROAD 620 S STE 250
Practice Address - Street 2:
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78734-6340
Practice Address - Country:US
Practice Address - Phone:512-619-3514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-10
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX230561223G0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice