Provider Demographics
NPI:1992844724
Name:BAKER III, JOSEPH WILLIS (DDS)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:WILLIS
Last Name:BAKER III
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 1:3101 N CYPRESS ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-4017
Mailing Address - Country:US
Mailing Address - Phone:316-685-9276
Mailing Address - Fax:316-634-1781
Practice Address - Street 1:3101 N CYPRESS ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-4017
Practice Address - Country:US
Practice Address - Phone:316-685-9276
Practice Address - Fax:316-634-1781
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS604211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice