Provider Demographics
NPI:1538170949
Name:BAKER, STEVEN R (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:R
Last Name:BAKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4121 W 83RD ST
Mailing Address - Street 2:STE 137
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-5300
Mailing Address - Country:US
Mailing Address - Phone:913-381-4700
Mailing Address - Fax:913-381-2673
Practice Address - Street 1:4121 W 83RD ST
Practice Address - Street 2:STE 137
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-5300
Practice Address - Country:US
Practice Address - Phone:913-381-4700
Practice Address - Fax:913-381-2673
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS59551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice