Provider Demographics
NPI:1760371819
Name:BAIG, VIRDA (BDS)
Entity type:Individual
Prefix:
First Name:VIRDA
Middle Name:
Last Name:BAIG
Suffix:
Gender:F
Credentials:BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3040 S MOUNT ZION RD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62521-9771
Mailing Address - Country:US
Mailing Address - Phone:217-864-4494
Mailing Address - Fax:
Practice Address - Street 1:3040 S MOUNT ZION RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62521-9771
Practice Address - Country:US
Practice Address - Phone:217-864-4494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.036219122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist