Vivian Hyun Jin Bae, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE9984 Issued in WA

Practice address

20710 1St Ave S
Des Moines, WA 98198-2849

Phone

(206) 878-8180

Fax

(206) 878-5823

NPI assigned

Nov 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315785600000",
    "number": "1194898007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16320 SE 66TH ST",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980065653",
            "telephone_number": "425-747-7422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20710 1ST AVE S",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981982849",
            "telephone_number": "206-878-8180",
            "fax_number": "206-878-5823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAE",
        "first_name": "VIVIAN",
        "middle_name": "HYUN JIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2011-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE9984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sayaka Kondo Arimoto, D.D.S.
• Bella Y. Arshinova, PA-C
• Joseph Stephen Augustyn, RDMS, RVT, RMSK
• Araceli Avendano, INTERPRETER
• Faith Irene Awuor
• Assiatu Barrie Bah, MD
• Deana Anne Bailey, OTR/L
• Bruce James Baker, PT
• Priska Baker
• Camryn T Barbosa, BS, RBT, MA, LABA

• General Practice Dentistry in Des Moines, WA
• Providers in Des Moines, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.