Provider Demographics
NPI:1588793277
Name:BARAKAT, JOHN HABIB (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HABIB
Last Name:BARAKAT
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 1:6940 FAIR OAKS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-3313
Mailing Address - Country:US
Mailing Address - Phone:916-972-0770
Mailing Address - Fax:916-972-9992
Practice Address - Street 1:6940 FAIR OAKS BLVD STE A
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-3313
Practice Address - Country:US
Practice Address - Phone:916-972-0770
Practice Address - Fax:916-972-9992
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA458181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice