Healthcare Provider Details

I. General information

NPI: 1023440120
Provider Name (Legal Business Name): SOPHIE L. BAIRD DDS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2013
Last Update Date: 04/16/2025
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 TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number8028
License Number StateAZ

VIII. Authorized Official

Name: SOPHIE LIAMIDI BAIRD
Title or Position: PRESIDENT
Credential: DDS
Phone: 832-724-7898