Provider Demographics
NPI:1821010216
Name:BARNETTE, JONATHAN HOLMES (DMD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:HOLMES
Last Name:BARNETTE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 HIGHWAY 78 E
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501-8803
Mailing Address - Country:US
Mailing Address - Phone:205-387-2681
Mailing Address - Fax:205-387-7865
Practice Address - Street 1:4801 HIGHWAY 78 E
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-8803
Practice Address - Country:US
Practice Address - Phone:205-387-2681
Practice Address - Fax:205-387-7865
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL#46831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510-26408OtherALABAMA BLUE CROSS PROVID
AK84726OtherUNITED CONCORDIA PROVIDER