Provider Demographics
NPI:1891876595
Name:BAYLON BEINLICH DDS LLC
Entity Type:Organization
Organization Name:BAYLON BEINLICH DDS LLC
Other - Org Name:PEDIATRIC DENTISTRY
Other - Org Type:Other Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:S
Authorized Official - Last Name:BEINLICH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,MS
Authorized Official - Phone:651-702-1462
Mailing Address - Street 1:5972 CAHILL AVE
Mailing Address - Street 2:SUITE 112
Mailing Address - City:INVER GROVE HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55076-5500
Mailing Address - Country:US
Mailing Address - Phone:651-450-0487
Mailing Address - Fax:651-450-1290
Practice Address - Street 1:9950 VALLEY CREEK RD
Practice Address - Street 2:SUITE 150
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-4883
Practice Address - Country:US
Practice Address - Phone:651-702-1462
Practice Address - Fax:651-702-3828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN29891281223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty