Provider Demographics
NPI:1538331244
Name:BARTON, JANIER PATRICE
Entity Type:Individual
Prefix:
First Name:JANIER
Middle Name:PATRICE
Last Name:BARTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3769 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-3327
Mailing Address - Country:US
Mailing Address - Phone:252-443-0048
Mailing Address - Fax:252-443-4796
Practice Address - Street 1:3769 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-3327
Practice Address - Country:US
Practice Address - Phone:252-443-0048
Practice Address - Fax:252-443-4796
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-02
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8747122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5911506Medicaid