Individual provider Active NPI

Junho Baik, D.D.S.

  • General Practice Dentistry
  • Northbrook, IL
National Provider Identifier
1053464032
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019023294 Issued in IL
Practice address
3340 Dundee Rd Ste 2N1
Northbrook, IL 60062-2332
Phone
(847) 480-2292
Fax
(847) 728-8724
NPI assigned
Jan 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019023294 IL Primary

Addresses

Primary practice location

3340 Dundee Rd Ste 2N1
Northbrook, IL 60062-2332

Mailing address

3340 Dundee Rd
Ste 2N1
Northbrook, IL 60062-2332
Phone (847) 480-2292

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160330002713 IL Order and Referring Only - Other (Non-Physician) 9830496157

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019023294ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dundee Dental Center, LTD. General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1053464032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 DUNDEE RD",
            "address_2": "STE 2N1",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622332",
            "telephone_number": "847-480-2292",
            "fax_number": "847-480-2293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 DUNDEE RD STE 2N1",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622332",
            "telephone_number": "847-480-2292",
            "fax_number": "847-728-8724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIK",
        "first_name": "JUNHO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-21",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019023294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.