Individual provider Active NPI

Juan Sebastian Baez Desangles

  • Dentist
  • Beachwood, OH
National Provider Identifier
1003740861
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
RES.005136 Issued in OH
Practice address
22901 Millcreek Blvd Ste 200
Beachwood, OH 44122-5721
Phone
(863) 331-2465
NPI assigned
Jun 9, 2026
Last updated
Jun 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X RES.005136 OH Primary

Addresses

Primary practice location

22901 Millcreek Blvd Ste 200
Beachwood, OH 44122-5721

Mailing address

2828 Euclid Ave
Cleveland, OH 44115-2455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1780963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1003740861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441152455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22901 MILLCREEK BLVD STE 200",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225721",
            "telephone_number": "863-331-2465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAEZ DESANGLES",
        "first_name": "JUAN",
        "middle_name": "SEBASTIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-06-09",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "RES.005136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.