Provider Demographics
NPI:1841381985
Name:BATES, STEVEN RONALD (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:RONALD
Last Name:BATES
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 1:503 ELM
Mailing Address - Street 2:BOX 26, SUITE 1
Mailing Address - City:WAMEGO
Mailing Address - State:KS
Mailing Address - Zip Code:66547-0026
Mailing Address - Country:US
Mailing Address - Phone:785-456-2330
Mailing Address - Fax:785-456-9740
Practice Address - Street 1:503 ELM
Practice Address - Street 2:BOX 26, SUITE 1
Practice Address - City:WAMEGO
Practice Address - State:KS
Practice Address - Zip Code:66547-0026
Practice Address - Country:US
Practice Address - Phone:785-456-2330
Practice Address - Fax:785-456-9740
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS58891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS10022300COtherDONATED DENTAL SERVICES
KS82564OtherUNITED CONCORDIA TRICARE
KS116642OtherBCBSKS INSURANCE PROVIDER