Healthcare Provider Details

I. General information

NPI: 1134319213
Provider Name (Legal Business Name): SOPHIE LIAMIDI BAIRD D.D.S., MS.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. SOPHIE ADEBISSI LIAMIDI

II. Dates (important events)

Enumeration Date: 07/26/2007
Last Update Date: 09/20/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2096 N KOLB RD SUITE 108
TUCSON AZ
85715
US

IV. Provider business mailing address

2096 N KOLB RD SUITE 108
TUCSON AZ
85715
US

V. Phone/Fax

Practice location:
  • Phone: 520-748-7073
  • Fax: 520-777-7372
Mailing address:
  • Phone: 520-748-7073
  • Fax: 520-777-7372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number23500
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number8028
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: