Healthcare Provider Details

I. General information

NPI: 1356803662
Provider Name (Legal Business Name): SARAH BAIK DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2019
Last Update Date: 09/22/2020
Certification Date: 09/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

424 19TH AVE E APT 101
SEATTLE WA
98112-5350
US

IV. Provider business mailing address

424 19TH AVE E APT 101
SEATTLE WA
98112-5350
US

V. Phone/Fax

Practice location:
  • Phone: 509-592-6025
  • Fax:
Mailing address:
  • Phone: 509-592-6025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number61015642
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: