=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134235401
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MICHAEL ERNEST WEBER DDS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/21/2006
-----------------------------------------------------
Last Update Date | 05/31/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4301 HUNTOON ST SUITE #6
-----------------------------------------------------
City | TOPEKA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-273-2922
-----------------------------------------------------
Fax | 785-272-1404
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2930 SW WANAMAKER DR STE 7
-----------------------------------------------------
City | TOPEKA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66614-4116
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-273-2922
-----------------------------------------------------
Fax | 785-272-1404
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | KS6497
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------