Provider Demographics
NPI:1023393816
Name:BARNETT, JOHN P (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:BARNETT
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 1:1366 STONY BROOK RD
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-2204
Mailing Address - Country:US
Mailing Address - Phone:631-751-8338
Mailing Address - Fax:
Practice Address - Street 1:1366 STONY BROOK RD
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790-2204
Practice Address - Country:US
Practice Address - Phone:631-751-8338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0437251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice