Erica Bae

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

104859 Issued in CA

Practice address

5730 Cottle Rd Ste 240
San Jose, CA 95123-3764

Phone

(408) 203-7494

NPI assigned

Feb 26, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Erica Hyunji Bae Professional name

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": "1393372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1912322983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5730 COTTLE RD STE 240",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951233764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5730 COTTLE RD STE 240",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951233764",
            "telephone_number": "408-203-7494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAE",
        "first_name": "ERICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-26",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02521500",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "104859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERICA",
            "last_name": "BAE",
            "middle_name": "HYUNJI",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Meghan Badinelli, RN
• Trisha Badong, NP
• Badoni Behavioral Services LLC
• Parvati Badoni
• Mohamad Sharif Badri, M.D.
• Soungyeon Helen Bae, D.C.
• Yong Bae
• Stephanie Baek
• Yanett Susana Baez-Melchor
• Abril J Baez

• General Practice Dentistry in San Jose, CA
• Providers in San Jose, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; 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.