SUSAN BAE, DDS, MS, INC. (NPI# 1780179176) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780179176 |
| Entity Type | Organization |
| Organization Name | SUSAN BAE, DDS, MS, INC. |
| Practice Address |
1921 E 4th St Ontario CA 91764-2603 |
| Mailing Address |
325 N Larchmont Blvd Ste 127 Los Angeles CA 90004-3011 |
| Practice Telephone | 4242563967 |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2019-11-06 |
| Authorized Official Name | SUSAN BAE (CEO) |
| Authorized Official Telephone | 4242563967 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
100794 | CA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 100794 | 05 |
| Street Address |
1921 E 4TH ST |
| City | ONTARIO |
| State | CA |
| Zip Code | 91764-2603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043249436 | Michael Min | Dentist | 1921 E 4th St, Ontario, CA 91764-2603 | 2006-06-30 |
| 1245390244 | Michael J. Min, Dds Inc | Dentist | 1921 E 4th St, Ontario, CA 91764-2603 | 2006-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760096952 | Jacqueline Iriart | Behavior Technician | 2930 Inland Empire Blvd St 100, Ontario, CA 91764 | 2020-09-03 |
| 1306459573 | Loremari Samantha Mohr | Assistant Behavior Analyst | 4688 Ontario Mills Parkwar, Ontario, CA 91764 | 2020-08-28 |
| 1023629649 | Yazmin Ramos | Behavior Technician | 4688 Ontario Mills Pwky, Ontario, CA 91764 | 2020-08-17 |
| 1184234999 | Adoniram Morales | Behavior Technician | 4688 Ontatio Mills Parkway, Ontario, CA 91764 | 2020-08-06 |
| 1396395489 | Enhanced Sleep Solutions | Clinic/Center | 2990 E. Inland Empire Blvd. #105, Antonio, CA 91764 | 2019-09-19 |
| 1013561588 | Jaquelyn Herrera | Behavior Technician | 2151 E Convention Center Way Ste #103, Ontario, CA 91764 | 2019-08-01 |
| 1285287995 | Ha Tran Tsai Dental Corporation | Dentist | 1361 East 4th Street, Ontario, CA 91764 | 2019-07-22 |
| 1346702974 | Rocio Sandoval | Behavior Technician | 800 Ferrari Ln Ste 100, Ontario, CA 91764 | 2019-04-02 |
| 1275011678 | Jquana Lucille Dowdy | Behavior Technician | 2903 Inland Empire Blvd, Suite 101, Ontario, CA 91764 | 2018-07-30 |
| 1063917458 | Maria Veronica Heard | Specialist/Technologist | 740 E Princeton St, Ontario, CA 91764 | 2018-03-27 |
| Find all providers in zip 91764 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215054044 | Christopher Scott Norton | Dentist | 745 Franklin Ave Ste 102, Ontario, CA 91764 | 2007-03-25 |
| 1215077508 | Reena Khullar | Dentist | 3333 Concours, Suite #201, Ontario, CA 91764-4875 | 2007-02-07 |
| 1316939887 | John Paul Barinaga | Dentist | 780 W Idaho Ave, Ontario, OR 97914-2256 | 2005-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861091720 | Ellen Im Dds Inc | Dentist | 13422 Pomerado Rd Ste 201, Poway, CA 92064-3548 | 2020-10-21 |
| 1104425370 | Jack Bayraymyan Dental Group Inc. | Dentist | 2621 Zoe Ave Ste A, Huntington Park, CA 90255-4131 | 2020-10-20 |
| 1669071825 | Jack Bayraymyan Dental Group Inc. | Dentist | 418 E Glenoaks Blvd Ste 202, Glendale, CA 91207-2093 | 2020-10-20 |
| 1891394060 | Jack Bayraymyan Dental Group Inc. | Dentist | 600 S Alvarado St Ste 200-201, Los Angeles, CA 90057-3314 | 2020-10-20 |
| 1790391209 | Two Front Corp | Dentist | 2408 Grandview Ave, Venice, CA 90291-4938 | 2020-09-21 |
| 1396358453 | Bridget Powers | Dentist | 1000 Ygnacio Valley Rd, Walnut Creek, CA 94598-1812 | 2020-08-28 |
| 1144832221 | Manjeet Samra Dental Corporation | Dentist | 1700 Mchenry Ave Ste 16b, Modesto, CA 95350-4319 | 2020-08-19 |
| 1154932150 | Jacqueline Morgan Payne | Dentist | 1820 Sonoma Ave Ste 36, Santa Rosa, CA 95405-6617 | 2020-08-12 |
| 1922617802 | Andrew Levin | Dentist | 7891 Talbert Ave # 2, Huntington Beach, CA 92648-8612 | 2020-07-27 |
| 1861001885 | Robert Berger | Dentist | 2529 Via Sanchez, Palos Verdes Estates, CA 90274-2805 | 2020-07-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.