Baek Dental Group

Primary specialty

DentistTaxonomy code 122300000X

License

DS037069 Issued in PA

Legal business name

BAEK DENTAL GROUP

Doing business as

Ryan Baek Dental

Practice address

428 Pennsylvania Ave
Fort Washington, PA 19034-3413

Phone

(215) 643-0300

Fax

(215) 643-0333

NPI assigned

Jan 14, 2015

Last updated

Jan 14, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

RYAN BAEK DENTAL, LLCAs reported in NPPES

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

Authorized official

Name

Aeri (Katie) Baek

Title

Office Manager

Phone

(215) 643-0300

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ryan Baek Dental Doing business as

Part of

Ryan Baek Dental

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Ryan Baek Dental

  • General Practice Dentistry
  • East Norriton, PA
  • NPI 1235575150
  NPPES parent name

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

{
    "created_epoch": "1421193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421193600000",
    "number": "1144619180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 PENNSYLVANIA AVE",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "190343413",
            "telephone_number": "215-643-0300",
            "fax_number": "215-643-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 PENNSYLVANIA AVE",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "190343413",
            "telephone_number": "215-643-0300",
            "fax_number": "215-643-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAEK DENTAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RYAN BAEK DENTAL, LLC",
        "enumeration_date": "2015-01-14",
        "last_updated": "2015-01-14",
        "status": "A",
        "authorized_official_last_name": "BAEK",
        "authorized_official_first_name": "AERI (KATIE)",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "215-643-0300"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS037069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101930230",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ryan Baek Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alexander L Avallon Jr., ATC
• Axia Abington Surgery Center, LLC
• Saida Azimbegova, CLINICIAN
• David J Badolato, MD
• Yeong J Bae, LCSW, M.DIV
• Thomas J Balshi, D.D.S.
• Casey Lee Barry, MD
• Katherine Elizabeth Bartosik, MED, ATC
• Melinda L Bartscherer, PT
• Mari Mumta Batta, D.O.

• Dentist in Fort Washington, PA
• Providers in Fort Washington, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2015; 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.