Provider Demographics
NPI:1821474776
Name:JAY E. BAUMAN DDS APDC
Entity Type:Organization
Organization Name:JAY E. BAUMAN DDS APDC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:E
Authorized Official - Last Name:BAUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-532-0888
Mailing Address - Street 1:1110 E CHAPMAN AVE
Mailing Address - Street 2:STE 102
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866
Mailing Address - Country:US
Mailing Address - Phone:714-532-0888
Mailing Address - Fax:714-532-0066
Practice Address - Street 1:1110 E CHAPMAN AVE
Practice Address - Street 2:STE 102
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866
Practice Address - Country:US
Practice Address - Phone:714-532-0888
Practice Address - Fax:714-532-0066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38491122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty