Healthcare Provider Details

I. General information

NPI: 1417244146
Provider Name (Legal Business Name): JOSEPH WILLIAM BARNHART DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2011
Last Update Date: 09/22/2020
Certification Date: 09/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1406 HWY S
VIENNA MO
65582-0999
US

IV. Provider business mailing address

PO BOX 999
VIENNA MO
65582-0999
US

V. Phone/Fax

Practice location:
  • Phone: 573-422-3612
  • Fax: 573-422-3712
Mailing address:
  • Phone: 573-422-3612
  • Fax: 573-422-3712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2011014522
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: