Healthcare Provider Details

I. General information

NPI: 1104783398
Provider Name (Legal Business Name): VISHAL MADHUKAR BARI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 S AMITY RD
CONWAY AR
72032-8090
US

IV. Provider business mailing address

12600 E COLFAX AVE UNIT 382
AURORA CO
80011-5542
US

V. Phone/Fax

Practice location:
  • Phone: 501-764-4465
  • Fax:
Mailing address:
  • Phone: 720-788-7681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: