Active NPI
Orson Young Baek, DDS MS
- Periodontics
- Norcross, GA
National Provider Identifier
1902968506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 013296
- Practice address
- 6060 McDonough Dr
Suite I
Norcross, GA 30093 - Phone
- (770) 448-3030
- Fax
- (770) 447-4906
- NPI assigned
- Dec 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 013296 | GA | Primary |
Addresses
Primary practice location
6060 McDonough Dr
Suite I
Norcross, GA 30093
Mailing address
1650 Oakbrook Dr
Suite 440
Norcorss, GA 30093
Phone (770) 446-8000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013296 | GA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902968506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1650 OAKBROOK DR",
"address_2": "SUITE 440",
"city": "NORCORSS",
"state": "GA",
"postal_code": "30093",
"telephone_number": "770-446-8000",
"fax_number": "770-446-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6060 MCDONOUGH DR",
"address_2": "SUITE I",
"city": "NORCROSS",
"state": "GA",
"postal_code": "30093",
"telephone_number": "770-448-3030",
"fax_number": "770-447-4906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAEK",
"first_name": "ORSON",
"middle_name": "YOUNG",
"name_prefix": "Dr.",
"credential": "DDS MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "GA",
"license": "013296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norcross, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.