Provider Demographics
NPI:1083809933
Name:BAICY, SARAH ANN (DMD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ANN
Last Name:BAICY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:798 SOUTHPARK BLVD
Mailing Address - Street 2:SUITE 26
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-3615
Mailing Address - Country:US
Mailing Address - Phone:804-520-1177
Mailing Address - Fax:
Practice Address - Street 1:798 SOUTHPARK BLVD
Practice Address - Street 2:SUITE 26
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-3615
Practice Address - Country:US
Practice Address - Phone:804-520-1177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401411929122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist