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General NPI Number Information
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NPI Number | 1114016441
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Entity Type | Individual
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Provider Name | JOSEPH G BABA DDS
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Gender | Male
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 03/16/2016
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Provider Practice Location Address
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Address Line | 4620 E DOUGLAS AVE STE 102
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City | WICHITA
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State | KS
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Zip | 67208-3900
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Country | US
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Telephone | 316-263-2444
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Fax | 316-260-2401
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Provider Business Mailing Address
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Address Line | 4620 E DOUGLAS AVE STE 102
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City | WICHITA
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State | KS
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Zip | 67208-3900
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Country | US
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Telephone | 316-263-2444
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Fax | 316-260-2401
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 5883
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 5883
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License Number State | KS
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