Provider Demographics
NPI:1689308033
Name:BARNES, ANDRE LAMONT III
Entity Type:Individual
Prefix:
First Name:ANDRE
Middle Name:LAMONT
Last Name:BARNES
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 GRACIE RD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23325-2606
Mailing Address - Country:US
Mailing Address - Phone:757-402-1591
Mailing Address - Fax:
Practice Address - Street 1:649 NEW GUINEA RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-8124
Practice Address - Country:US
Practice Address - Phone:757-422-7077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist