| Joshua Baek D.d.s. Inc. | |
|
7604 Reseda Blvd Reseda CA 91335-2822 | |
| (818) 343-3916 | |
| Not Available |
| Full Name | Joshua Baek D.d.s. Inc. |
|---|---|
| Speciality | Dentist |
| Location | 7604 Reseda Blvd, Reseda, California |
| Authorized Official Name and Position | Joshua Baek (OWNER) |
| Authorized Official Contact | 8184971222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Joshua Baek D.d.s. Inc. 7604 Reseda Blvd Reseda CA 91335-2822 Ph: (818) 343-3916 | Joshua Baek D.d.s. Inc. 7604 Reseda Blvd Reseda CA 91335-2822 Ph: (818) 343-3916 |
| NPI Number | 1578137873 |
|---|---|
| Provider Enumeration Date | 05/20/2021 |
| Last Update Date | 05/20/2021 |
| Medicare PECOS PAC ID | 3870999204 |
|---|---|
| Medicare Enrollment ID | O20210909001553 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578137873 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | Joshua Baek |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1174176598 PECOS PAC ID: 4789080110 Enrollment ID: I20210909001609 |
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