Provider Demographics
NPI:1669626511
Name:BAHA, JOSEPH SAYED (DDS)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:SAYED
Last Name:BAHA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26756 BARONET
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-4174
Mailing Address - Country:US
Mailing Address - Phone:518-227-2703
Mailing Address - Fax:
Practice Address - Street 1:1220 W GLENOAKS BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91201-2231
Practice Address - Country:US
Practice Address - Phone:518-227-2703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA629321223G0001X, 122300000X
NY054219-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice