Provider Demographics
NPI:1871747238
Name:BAUMHARDT, HEATHER ILYCIA (DDS)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:ILYCIA
Last Name:BAUMHARDT
Suffix:
Gender:F
Credentials:DDS
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Other - Credentials:
Mailing Address - Street 1:3RD FLOOR MAIN HOSPITAL BLDG
Mailing Address - Street 2:CHILDREN'S HOSPITAL DRIVE, 45TH AND PENN
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15201
Mailing Address - Country:US
Mailing Address - Phone:412-692-5387
Mailing Address - Fax:412-692-7946
Practice Address - Street 1:3RD FLOOR MAIN HOSPITAL BLDG
Practice Address - Street 2:CHILDREN'S HOSPITAL DRIVE, 45TH AND PENN
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15201
Practice Address - Country:US
Practice Address - Phone:412-692-5387
Practice Address - Fax:412-692-7946
Is Sole Proprietor?:No
Enumeration Date:2008-11-12
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY052841122300000X
PADS0378031223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist