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General NPI Number Information
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NPI Number | 1619513074
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Entity Type | Individual
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Provider Name | LLOYD SEUNG BAIK DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 11/20/2019
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Last Update Date | 12/28/2022
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Provider Practice Location Address
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Address Line | 260 W FOOTHILL BLVD
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City | RIALTO
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State | CA
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Zip | 92376-5048
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Country | US
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Telephone | 909-546-7064
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Fax |
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Provider Business Mailing Address
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Address Line | 7601 IMPERIAL HWY
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City | DOWNEY
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State | CA
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Zip | 90242-3456
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 105352
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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