Healthcare Provider Details

I. General information

NPI: 1225445596
Provider Name (Legal Business Name): AARON BAIRD DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2014
Last Update Date: 07/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 N 1ST AVE
STAYTON OR
97383-1703
US

IV. Provider business mailing address

442 SW UMATILLA AVE SUITE 200
REDMOND OR
97756-7039
US

V. Phone/Fax

Practice location:
  • Phone: 888-468-0022
  • Fax: 541-504-3907
Mailing address:
  • Phone: 541-504-3900
  • Fax: 541-504-3907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number10050
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: