Barbara Daniela Olivos Bazaes, DDS, MS

Primary specialty

DentistTaxonomy code 122300000X

License

PVRTP11923 Issued in MS

Practice address

2500 N State St
Jackson, MS 39216-4500

Phone

(601) 984-6110

NPI assigned

Jul 10, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Networks

• devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
• devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
• TN PPO
• MS PPO D-SNP
• LA PPO C-SNP
• MS PPO C-SNP
• devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
• AL HMO
• AL HMO D-SNP
• MS PPO
• TN PPO C-SNP

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1003594938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 COMSTOCK LN",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391108364",
            "telephone_number": "769-253-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVOS BAZAES",
        "first_name": "BARBARA",
        "middle_name": "DANIELA",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "PVRTP11923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Olewiler, MS, CGC
• Ann C Oliver, APRN
• Beverly Eaves Oliver, N.P.
• Joseph A Oliver, M.D.
• Stephanie Pieroni Oliver, MS, CCC-SLP
• Phyllis S Ollie, RRT
• Danny J Olmi
• Emma Grace Olsen
• Amy J Olson, R.D., C.D.E.
• Babatunde Olutade, MD

• All providers in Jackson, MS
• Dentist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.