Healthcare Provider Details

I. General information

NPI: 1043142995
Provider Name (Legal Business Name): ALI TALEB DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3151 N ROCK RD
WICHITA KS
67226-1312
US

IV. Provider business mailing address

3151 N ROCK RD
WICHITA KS
67226-1312
US

V. Phone/Fax

Practice location:
  • Phone: 316-272-7876
  • Fax:
Mailing address:
  • Phone: 316-272-7876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number62343
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: