Provider Demographics
NPI:1811378706
Name:BARDEN, DEANNA (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:
Last Name:BARDEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11644 W 75TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66214-1372
Mailing Address - Country:US
Mailing Address - Phone:913-962-0036
Mailing Address - Fax:
Practice Address - Street 1:11644 W 75TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66214-1372
Practice Address - Country:US
Practice Address - Phone:913-962-0036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-16
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS61202122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist