Provider Demographics
NPI:1063753242
Name:BAIR, JIN-HWEI JULIANNA (DMD)
Entity type:Individual
Prefix:
First Name:JIN-HWEI JULIANNA
Middle Name:
Last Name:BAIR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:JULIANNA
Other - Middle Name:
Other - Last Name:BAIR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:1148 UNION ST APT 3E
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-1444
Mailing Address - Country:US
Mailing Address - Phone:862-245-1359
Mailing Address - Fax:
Practice Address - Street 1:1148 UNION ST APT 3E
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-1444
Practice Address - Country:US
Practice Address - Phone:862-245-1359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-13
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY057800-11223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program