Healthcare Provider Details

I. General information

NPI: 1053528851
Provider Name (Legal Business Name): R. WILLIAM BARNARD DDS, MS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 06/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14707 CALIFORNIA ST STE 8
OMAHA NE
68154-1900
US

IV. Provider business mailing address

14707 CALIFORNIA ST STE 8
OMAHA NE
68154-1900
US

V. Phone/Fax

Practice location:
  • Phone: 402-498-5800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number5270
License Number StateNE

VIII. Authorized Official

Name: DR. RICHARD WILLIAM BARNARD
Title or Position: DOCTOR
Credential: DDS, MS, PC
Phone: 402-498-5800