Provider Demographics
NPI:1144580622
Name:BARNEY, JOHN S (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:S
Last Name:BARNEY
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:PO BOX 100
Mailing Address - Street 2:605 W. 1ST ST.
Mailing Address - City:WARDEN
Mailing Address - State:WA
Mailing Address - Zip Code:98857-0100
Mailing Address - Country:US
Mailing Address - Phone:509-349-7420
Mailing Address - Fax:
Practice Address - Street 1:605 W 1ST ST.
Practice Address - Street 2:
Practice Address - City:WARDEN
Practice Address - State:WA
Practice Address - Zip Code:98857
Practice Address - Country:US
Practice Address - Phone:509-349-7420
Practice Address - Fax:509-349-2357
Is Sole Proprietor?:No
Enumeration Date:2012-05-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 4049122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist