MEDICARE: DR. JI H BAAG DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	38081	TX
2	1223E0200X	Endodontics	S7-132C	NV

General Provider Information

NPI Number	:	1689875395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JI H BAAG DDS

Provider Business Mailing Address
First Line	:	5453 S DURANGO DR UNIT 2007
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-2262
Country	:	US
Telephone Number	:	310-999-4958
Fax Number	:

Provider Business Practice Location Address
First Line	:	7125 N DURANGO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-4466
Country	:	US
Telephone Number	:	702-658-2311
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2007
Last Update Date	:	05/09/2023

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