Provider Demographics
NPI:1033366281
Name:BARNES, CAITLIN GRACEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:GRACEY
Last Name:BARNES
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 1:2600 DENALI ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-2746
Mailing Address - Country:US
Mailing Address - Phone:907-334-9543
Mailing Address - Fax:907-334-9007
Practice Address - Street 1:2600 DENALI ST
Practice Address - Street 2:SUITE 500
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2746
Practice Address - Country:US
Practice Address - Phone:907-334-9543
Practice Address - Fax:907-334-9007
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1238122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKDDG039Medicaid