Healthcare Provider Details

I. General information

NPI: 1831346568
Provider Name (Legal Business Name): ANITTA BARNABAS DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2008
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3609 GENERAL ELECTRIC RD
BLOOMINGTON IL
61704-8766
US

IV. Provider business mailing address

3609 GENERAL ELECTRIC RD
BLOOMINGTON IL
61704-8766
US

V. Phone/Fax

Practice location:
  • Phone: 646-346-3316
  • Fax:
Mailing address:
  • Phone: 646-346-3316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number019028128
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: