1316949142 NPI number — DR. JEFFREY D BAIRD DMD

Table of content: DR. JEFFREY D BAIRD DMD (NPI 1316949142)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316949142 NPI number — DR. JEFFREY D BAIRD DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BAIRD
Provider First Name:
JEFFREY
Provider Middle Name:
D
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DMD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316949142
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/24/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
03/22/2006
NPI Reactivation Date:
03/29/2006

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1075 HARRISON CITY EXPORT RD
Provider Second Line Business Mailing Address:
SUITE #3
Provider Business Mailing Address City Name:
JEANNETTE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15644-4309
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-744-2099
Provider Business Mailing Address Fax Number:
724-744-3030

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1075 HARRISON CITY EXPORT RD
Provider Second Line Business Practice Location Address:
SUITE #3
Provider Business Practice Location Address City Name:
JEANNETTE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15644-4309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-744-2099
Provider Business Practice Location Address Fax Number:
724-744-3030
Provider Enumeration Date:
08/11/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  DS026919L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2211 . This is a "DORAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 575692 . This is a "UNITED CONCORDIA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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