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General NPI Number Information
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NPI Number | 1013049634
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Entity Type | Individual
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Provider Name | ANDREA LOU BAUMANN DDS MS
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Gender | Female
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 12/14/2025
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Provider Practice Location Address
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Address Line | 126 W BOND AVE
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City | WEST MEMPHIS
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State | AR
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Zip | 72301-3909
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Country | US
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Telephone | 870-735-7805
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Fax | 870-735-7853
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Provider Business Mailing Address
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Address Line | 460 TENNESSEE ST APT 301
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City | MEMPHIS
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State | TN
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Zip | 38103-4484
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Country | US
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Telephone | 951-533-3563
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DT034816
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License Number State | CA
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