Provider Demographics
NPI:1518951912
Name:BARNETT, BARON G (DDS, PC)
Entity Type:Individual
Prefix:DR
First Name:BARON
Middle Name:G
Last Name:BARNETT
Suffix:
Gender:F
Credentials:DDS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7965 SW MOHAWK ST
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-9193
Mailing Address - Country:US
Mailing Address - Phone:503-692-0300
Mailing Address - Fax:503-691-6149
Practice Address - Street 1:7965 SW MOHAWK ST
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-9193
Practice Address - Country:US
Practice Address - Phone:503-692-0300
Practice Address - Fax:503-691-6149
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2007-07-08
Deactivation Date:2006-04-04
Deactivation Code:
Reactivation Date:2006-06-28
Provider Licenses
StateLicense IDTaxonomies
ORD51461223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics