1. Home
  2. Directory
  3. New Mexico
  4. Grants
  5. Dentist
  6. NPI Profile

DERRICK BACA DDS LLC
NPI 1902214406
Dentist - General Practice in Grants, NM

Active since July 28, 2014
1209 BONITA ST, GRANTS, NM 87020(505) 876-4034(505) 876-4036 Get Directions Write a Review

NPPES record last updated: July 28, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Derrick Baca Dds Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DERRICK BACA DDS LLC (NPI 1902214406) is a healthcare organization registered as a general practice in Grants, New Mexico and active in the NPI registry since July 2014. The organization lists Derrick R Baca, General Dentist, as its authorized official.

NPPES Registry Identity

NPI1902214406
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameDERRICK BACA DDS LLC
Location Address1209 BONITA STGrants, NM 87020-2103
Mailing Address1209 Bonita StGrants, NM 87020-2103 · (505) 876-4034 · Fax (505) 876-4036
Phone(505) 876-4034
Fax(505) 876-4036
Organization SubpartNo
Authorized OfficialDerrick R BacaGeneral Dentist · (505) 876-4034
Enumeration DateJuly 28, 2014
✔ NPI 1902214406 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in NM · DD3492
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
1209 BONITA ST, Grants, NM 87020
Open in Google Maps ↗

Other Identifiers 1

Medicaid93577389NM

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ROBIN SIMON BERRIN D.M.D.
Dentist (General Practice)
1209 BONITA ST
GRANTS, NM 87020
Cibola County (505) 876-4034
PATRICIA B. VALDIVIA D.D.S.,P.C.
Dentist (General Practice)
1209 BONITA ST
GRANTS, NM 87020
Cibola County (505) 876-4034
DR. MARCELLUS GLADNEY D.M.D.
Dentist (Pediatric Dentistry)
1209 BONITA ST
GRANTS, NM 87020
Cibola County (505) 876-4034
DR. PATRICIA B VALDIVIA DDS
Dentist (General Practice)
1209 BONITA ST
GRANTS, NM 87020
Cibola County (505) 876-4034

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Derrick Baca Dds LLC's NPI number?

The NPI number for Derrick Baca Dds LLC is 1902214406. It was assigned to this organization in the NPPES registry on July 28, 2014.

Where is Derrick Baca Dds LLC located?

Derrick Baca Dds LLC is located at 1209 Bonita St, Grants, NM 87020. The listed phone number is (505) 876-4034.

What is Derrick Baca Dds LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Derrick Baca Dds LLC was last updated on July 28, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.