Provider Demographics
NPI:1588700124
Name:BARRIX, SCOTT CHARLES (DDS)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:CHARLES
Last Name:BARRIX
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 NORTHPARK DR STE B
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47203-4482
Mailing Address - Country:US
Mailing Address - Phone:812-372-1234
Mailing Address - Fax:812-373-3373
Practice Address - Street 1:2525 CALIFORNIA ST
Practice Address - Street 2:SUITE F
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-3671
Practice Address - Country:US
Practice Address - Phone:812-372-1234
Practice Address - Fax:812-373-3373
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120090681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200010550AMedicaid