Leroy Baca, DDS in T Or C, NM - Medicare Dentist Provider

Leroy Baca, DDS - Medicare Dentist in T Or C, NM

Leroy Baca, DDS is a medicare enrolled "Dentist" provider in T Or C, New Mexico. His current practice location is 1960 N Date St, T Or C, New Mexico. You can reach out to his office (for appointments etc.) via phone at (505) 267-3088.

Leroy Baca is licensed to practice in New Mexico (license number DD1705) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1154314177.

Contact Information

	Leroy Baca, DDS
	1960 N Date St, T Or C, NM 87901-3701
	(505) 267-3088
	(505) 267-1747

Map and Direction

Healthcare Provider's Profile

Full Name	Leroy Baca
Gender	Male
Speciality	Dentist
Location	1960 N Date St, T Or C, New Mexico
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1154314177
Provider Enumeration Date: 08/24/2005
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 9133449333
Enrollment ID: I20150528001930

Medical Identifiers

Medical identifiers for Leroy Baca such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1154314177	NPI	-	NPPES
88079	Medicaid	NM

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	DD1705 (New Mexico)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Leroy Baca is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Leroy Baca, DDS 255 Hwy 187, P.o Box 370, Hatch, NM 87937-0370 Ph: (505) 267-3088	Leroy Baca, DDS 1960 N Date St, T Or C, NM 87901-3701 Ph: (505) 267-3088

Reviews and Comments

Dentist in T Or C, NM

Myrna L Policarpio, DDS Dentist Medicare: Medicare Enrolled Practice Location: 1960 N Date St, T Or C, NM 87901 Phone: 575-894-7662 Fax: 575-894-7930
Mark Wiatt, DDS Dentist Medicare: Medicare Enrolled Practice Location: 1960 N Date St, T Or C, NM 87901 Phone: 505-267-3088 Fax: 505-267-1747