Provider Demographics
NPI:1629681895
Name:BARNETT, ELIZABETH IRENE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:IRENE
Last Name:BARNETT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:IRENE
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2134 CAROL VIEW DR APT A213
Mailing Address - Street 2:
Mailing Address - City:CARDIFF BY THE SEA
Mailing Address - State:CA
Mailing Address - Zip Code:92007-1864
Mailing Address - Country:US
Mailing Address - Phone:858-335-2359
Mailing Address - Fax:
Practice Address - Street 1:14701 VIA BETTONA STE 215
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-4808
Practice Address - Country:US
Practice Address - Phone:858-759-7658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-27
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1053921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice