Provider Demographics
NPI:1003182478
Name:BAUM ORTHODONTICS, INC.
Entity type:Organization
Organization Name:BAUM ORTHODONTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL/INSURANCE ADM.
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAFYAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-208-5758
Mailing Address - Street 1:10921 WILSHIRE BLVD.
Mailing Address - Street 2:SUITE #804
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024
Mailing Address - Country:US
Mailing Address - Phone:310-208-5678
Mailing Address - Fax:310-208-1968
Practice Address - Street 1:10921 WILSHIRE BLVD.
Practice Address - Street 2:SUITE #804
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024
Practice Address - Country:US
Practice Address - Phone:310-208-5678
Practice Address - Fax:310-208-1968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-29
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty