Provider Demographics
NPI:1346392107
Name:BARNHILL PEDIATRIC DENTISTRY
Entity Type:Organization
Organization Name:BARNHILL PEDIATRIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:L
Authorized Official - Last Name:BARNHILL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:606-526-9636
Mailing Address - Street 1:129 S HIGHWAY 1223
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-4641
Mailing Address - Country:US
Mailing Address - Phone:606-526-9636
Mailing Address - Fax:606-526-9590
Practice Address - Street 1:129 S HIGHWAY 1223
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-4641
Practice Address - Country:US
Practice Address - Phone:606-526-9636
Practice Address - Fax:606-526-9590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY70071223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY45608734Medicaid