Provider Demographics
NPI:1184724288
Name:BABA, LINDA J (DDS)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:J
Last Name:BABA
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 1:38 LINDCOVE
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602
Mailing Address - Country:US
Mailing Address - Phone:714-669-9240
Mailing Address - Fax:714-669-9240
Practice Address - Street 1:301 W. BASTANCHURY RD.
Practice Address - Street 2:SUITE 110
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835
Practice Address - Country:US
Practice Address - Phone:714-316-5811
Practice Address - Fax:714-316-5813
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42314122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist