Mirinae Bak, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

010588 Issued in CT

Practice address

450 S Main St
New Britain, CT 06051-3551

Phone

(860) 223-2424

NPI assigned

Jul 21, 2011

Last updated

Jul 21, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1311206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311206400000",
    "number": "1609154830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 CLOVE BRANCH RD",
            "city": "HOPEWELL JUNCTION",
            "state": "NY",
            "postal_code": "125335221",
            "telephone_number": "845-242-3132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 S MAIN ST",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060513551",
            "telephone_number": "860-223-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAK",
        "first_name": "MIRINAE",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-21",
        "last_updated": "2011-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "010588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adem Aydin, MD
• Amaris Aurora Ayon
• B & R Dental, LLC (West Main Dental)
• Paige Elizabeth Baccaro
• Hershelle Bailey
• Howard N Baker, MD
• Kyle A Baker, M.D.
• Ali Reza Bakhshalizadeh, M.D.
• Helen Pobiechun Balaban, LPC, NCC
• Hanumanthiah Balakrishna, M.D.

• General Practice Dentistry in New Britain, CT
• Providers in New Britain, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.