Provider Demographics
NPI:1184468878
Name:BARNETT, TYE AYANA (DDS)
Entity type:Individual
Prefix:DR
First Name:TYE
Middle Name:AYANA
Last Name:BARNETT
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 1:1015 N 16TH ST APT 401
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68102-4447
Mailing Address - Country:US
Mailing Address - Phone:512-744-3857
Mailing Address - Fax:
Practice Address - Street 1:2320 W LOOP 340 STE 200B
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76711-2454
Practice Address - Country:US
Practice Address - Phone:254-230-9597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX406771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice