Provider Demographics
NPI:1083992655
Name:BARKER, KRISTYN LEANNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:KRISTYN
Middle Name:LEANNE
Last Name:BARKER
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 1:5123 SW TUMBLEWEED RD
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:KS
Mailing Address - Zip Code:67002-8243
Mailing Address - Country:US
Mailing Address - Phone:316-209-8959
Mailing Address - Fax:
Practice Address - Street 1:2046 N OLIVER AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-2503
Practice Address - Country:US
Practice Address - Phone:316-681-2425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-29
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS608481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice