Healthcare Provider Details

I. General information

NPI: 1497687875
Provider Name (Legal Business Name): SYDNEY ANNE BAUER DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1134 S NOLAND RD
INDEPENDENCE MO
64050-4560
US

IV. Provider business mailing address

481 AMBER LAKE CT
IMPERIAL MO
63052-3114
US

V. Phone/Fax

Practice location:
  • Phone: 816-357-5140
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2026022871
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: