Provider Demographics
NPI:1821100496
Name:BARRETT, ANDREA M (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:M
Last Name:BARRETT
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 1:812 HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-3157
Mailing Address - Country:US
Mailing Address - Phone:732-846-2494
Mailing Address - Fax:732-846-9397
Practice Address - Street 1:812 HAMILTON ST
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-3157
Practice Address - Country:US
Practice Address - Phone:732-846-2494
Practice Address - Fax:732-846-9397
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI153481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1035319OtherHORIZON NJ HEALTH
NJ0710OtherDELTA DENTAL
NJ125437249OtherUNITED HEALTH CARE DENTAL
NJ111234OtherAETNA
NJ150131OtherCIGNA
NJNJ0231OtherHORIZON DENTAL CHOICE
NJ2019205Medicaid
NJ0004157OtherMANAGED DENTAL GUARD