Provider Demographics
NPI:1831305523
Name:RICHARD R. BARBARO, D.D.S., PA
Entity Type:Organization
Organization Name:RICHARD R. BARBARO, D.D.S., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR.
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:BARBARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-867-8148
Mailing Address - Street 1:6523 DENTAL LN
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-0345
Mailing Address - Country:US
Mailing Address - Phone:910-867-8148
Mailing Address - Fax:910-867-7963
Practice Address - Street 1:6523 DENTAL LN
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-0345
Practice Address - Country:US
Practice Address - Phone:910-867-8148
Practice Address - Fax:910-867-7963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC52011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89-90401Medicaid