Provider Demographics
NPI:1609975598
Name:BABAN, NIAZ (DDS)
Entity Type:Individual
Prefix:DR
First Name:NIAZ
Middle Name:
Last Name:BABAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4920 DUBLIN BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-3169
Mailing Address - Country:US
Mailing Address - Phone:925-551-6464
Mailing Address - Fax:925-551-6465
Practice Address - Street 1:4920 DUBLIN BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-3169
Practice Address - Country:US
Practice Address - Phone:925-551-6464
Practice Address - Fax:925-551-6465
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA412321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice