Provider Demographics
NPI:1760172779
Name:YEU JIN BAIK, D.D.S., P.C.
Entity Type:Organization
Organization Name:YEU JIN BAIK, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:YEU JIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAIK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:516-640-6812
Mailing Address - Street 1:271 E SOUTHLAKE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6272
Mailing Address - Country:US
Mailing Address - Phone:817-329-6677
Mailing Address - Fax:
Practice Address - Street 1:271 E SOUTHLAKE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6272
Practice Address - Country:US
Practice Address - Phone:817-329-6677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty