Provider Demographics
NPI:1306993217
Name:BARNETT, DAVID I (DMD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:I
Last Name:BARNETT
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 1:819 W WILSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-1649
Mailing Address - Country:US
Mailing Address - Phone:714-871-3544
Mailing Address - Fax:714-871-3546
Practice Address - Street 1:819 W WILSHIRE AVE
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-1649
Practice Address - Country:US
Practice Address - Phone:714-871-3544
Practice Address - Fax:714-871-3546
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA304461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice