Healthcare Provider Details

I. General information

NPI: 1124333497
Provider Name (Legal Business Name): BARNES DENTAL CORPORATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2010
Last Update Date: 01/08/2021
Certification Date: 01/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2626 S. MOONEY BLVD, SUITE C
VISALIA CA
93277
US

IV. Provider business mailing address

2626 S. MOONEY BLVD. SUITE C
VISALIA CA
93277
US

V. Phone/Fax

Practice location:
  • Phone: 559-635-0206
  • Fax: 559-635-0211
Mailing address:
  • Phone: 559-635-0206
  • Fax: 559-635-0211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number38644
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number38644
License Number StateCA

VIII. Authorized Official

Name: MR. RICHARD W BARNES
Title or Position: DENTIST/OWNER
Credential: DENTIST DDS
Phone: 559-635-0206