Provider Demographics
NPI:1982959805
Name:BAYA, STEPHANIE STRAUSS (DMD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:STRAUSS
Last Name:BAYA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4635 GULFSTARR DR
Mailing Address - Street 2:
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541-5780
Mailing Address - Country:US
Mailing Address - Phone:850-598-7833
Mailing Address - Fax:
Practice Address - Street 1:4635 GULFSTARR DR
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-5780
Practice Address - Country:US
Practice Address - Phone:850-598-7833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN198291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice