Provider Demographics
NPI:1588968499
Name:BALDWIN, DAN W (DDS)
Entity type:Individual
Prefix:DR
First Name:DAN
Middle Name:W
Last Name:BALDWIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1499 WINDHORST WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-8800
Mailing Address - Country:US
Mailing Address - Phone:317-972-7889
Mailing Address - Fax:317-972-7969
Practice Address - Street 1:1499 WINDHORST WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-8800
Practice Address - Country:US
Practice Address - Phone:317-972-7889
Practice Address - Fax:317-972-7969
Is Sole Proprietor?:No
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5432122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist