Healthcare Provider Details

I. General information

NPI: 1255268710
Provider Name (Legal Business Name): BAUBAK BAGHI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 MUIR ST STE A
CAMBRIDGE MD
21613-1848
US

IV. Provider business mailing address

368 S PICKETT ST UNIT 9910
ALEXANDRIA VA
22304-8308
US

V. Phone/Fax

Practice location:
  • Phone: 410-228-9381
  • Fax:
Mailing address:
  • Phone: 202-709-5323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: