Provider Demographics
NPI:1649809161
Name:BAI, JESSICA HUI (DMD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:HUI
Last Name:BAI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:HUI
Other - Last Name:BAI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:12418 NE 157TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-7915
Mailing Address - Country:US
Mailing Address - Phone:857-264-6436
Mailing Address - Fax:
Practice Address - Street 1:13033 NE BEL RED RD STE 230
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2633
Practice Address - Country:US
Practice Address - Phone:425-454-1975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-06
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA611839951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice