MEDICARE: DR. ALEXIS TAYLOR BARNES DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	29379	FL

General Provider Information

NPI Number	:	1053159863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEXIS TAYLOR BARNES DMD

Provider Business Mailing Address
First Line	:	515 SW 18TH AVE UNIT 18
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-7519
Country	:	US
Telephone Number	:	727-543-1077
Fax Number	:

Provider Business Practice Location Address
First Line	:	2701 W OAKLAND PARK BLVD STE 101
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33311-1348
Country	:	US
Telephone Number	:	727-543-1077
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2024
Last Update Date	:	01/08/2026

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