Provider Demographics
NPI:1346536646
Name:BARNETT, CHRISTOPHER LEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:LEE
Last Name:BARNETT
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 1:2000 BRETTON CIR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-1284
Mailing Address - Country:US
Mailing Address - Phone:405-543-9620
Mailing Address - Fax:
Practice Address - Street 1:100 STARLITE DR
Practice Address - Street 2:
Practice Address - City:KINGFISHER
Practice Address - State:OK
Practice Address - Zip Code:73750-4944
Practice Address - Country:US
Practice Address - Phone:405-375-5855
Practice Address - Fax:405-375-5863
Is Sole Proprietor?:No
Enumeration Date:2011-06-24
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK62741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200385740AMedicaid