Samual Lee Bach, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D14759 Issued in MN

Practice address

1905 Plaza Dr
Eagan, MN 55122-2883

Phone

(651) 686-6800

NPI assigned

Jun 10, 2022

Last updated

Jun 17, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1386373603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 PLAZA DR",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551222883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 PLAZA DR",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551222883",
            "telephone_number": "651-686-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACH",
        "first_name": "SAMUAL",
        "middle_name": "LEE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-10",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D14759",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D145759",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abdul A Aziz
• Fatimata Ba
• Baby Love, LLC (BabyLove)
• Babylove Alliance LTD. (The BabyLove Alliance)
• Madeline Shirley Bach
• Back & Body Chiropractic
• Jessica Marie Backowski
• Precious Oluwabukaunmi Badejo
• Michael R Baer, M.D.
• Susan M Bailey, N.P.

• Dentist in Eagan, MN
• Providers in Eagan, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2022; 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.