Provider Demographics
NPI:1366821803
Name:BARBA, STEPHEN (DMD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:BARBA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 PAPALAUA STREET
Mailing Address - Street 2:STE 200
Mailing Address - City:LAHAINA
Mailing Address - State:HI
Mailing Address - Zip Code:96761
Mailing Address - Country:US
Mailing Address - Phone:808-667-7711
Mailing Address - Fax:
Practice Address - Street 1:154 PAPALAUA STREET
Practice Address - Street 2:STE 200
Practice Address - City:LAHAINA
Practice Address - State:HI
Practice Address - Zip Code:96761
Practice Address - Country:US
Practice Address - Phone:808-667-7711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-28
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-2599122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist