Provider Demographics
NPI:1235446642
Name:BARNETT, STEPHANIE (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:BARNETT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 SADDLE LN
Mailing Address - Street 2:
Mailing Address - City:SKIATOOK
Mailing Address - State:OK
Mailing Address - Zip Code:74070-3629
Mailing Address - Country:US
Mailing Address - Phone:918-812-9388
Mailing Address - Fax:
Practice Address - Street 1:360 PEAK ONE DR.
Practice Address - Street 2:SUITE 100
Practice Address - City:FRISCO
Practice Address - State:CO
Practice Address - Zip Code:80443
Practice Address - Country:US
Practice Address - Phone:970-668-4040
Practice Address - Fax:970-668-6699
Is Sole Proprietor?:No
Enumeration Date:2010-09-07
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00202111122300000X
OK62341223G0001X
CA596391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice