Healthcare Provider Details

I. General information

NPI: 1104731132
Provider Name (Legal Business Name): BARNI MOHAMED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7710 BROOKLYN BLVD FL 1
BROOKLYN PARK MN
55443-2979
US

IV. Provider business mailing address

13027 ERSKIN ST NE
BLAINE MN
55449-2211
US

V. Phone/Fax

Practice location:
  • Phone: 763-373-5533
  • Fax:
Mailing address:
  • Phone: 612-501-2191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code125J00000X
TaxonomyDental Therapist
License NumberDT210
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: