Provider Demographics
NPI:1033776844
Name:BAIK, HANNAH BOHYUN (DMD)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:BOHYUN
Last Name:BAIK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:BOHYUN
Other - Last Name:CHOE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4121 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-2951
Mailing Address - Country:US
Mailing Address - Phone:714-745-5288
Mailing Address - Fax:
Practice Address - Street 1:4121 E MAIN ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-2951
Practice Address - Country:US
Practice Address - Phone:614-853-3232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-28
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.025801122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist