Individual provider Active NPI

Joseph G Baba, DDS

  • Dentist
  • Wichita, KS
National Provider Identifier
1114016441
Registry record updated Mar 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5883 Issued in KS
Practice address
4620 E Douglas Ave Ste 102
Wichita, KS 67208-3900
Phone
(316) 263-2444
Fax
(316) 260-2401
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5883 KS
Dentist 122300000X 5883 KS Primary

Addresses

Primary practice location

4620 E Douglas Ave Ste 102
Wichita, KS 67208-3900

Mailing address

4620 E Douglas Ave Ste 102
Wichita, KS 67208-3900
Phone (316) 263-2444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Sep 1, 2015 through Sep 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5883KSMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458086400000",
    "number": "1114016441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4620 E DOUGLAS AVE STE 102",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672083900",
            "telephone_number": "316-263-2444",
            "fax_number": "316-260-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4620 E DOUGLAS AVE STE 102",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672083900",
            "telephone_number": "316-263-2444",
            "fax_number": "316-260-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BABA",
        "first_name": "JOSEPH",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2016-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "5883",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "5883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.