Provider Demographics
NPI:1356775522
Name:BAEZ, JOEL (DMD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:
Last Name:BAEZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 SE 6TH AVE STE B-1
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5264
Mailing Address - Country:US
Mailing Address - Phone:561-276-6684
Mailing Address - Fax:
Practice Address - Street 1:160 SE 6TH AVE STE B-1
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5264
Practice Address - Country:US
Practice Address - Phone:561-276-6684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-23
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN20243122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist