Healthcare Provider Details

I. General information

NPI: 1912093386
Provider Name (Legal Business Name): NANCY ANN BARNETT DDS, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 E SILVER SPRING DR SUITE 238
MILWAUKEE WI
53217-5274
US

IV. Provider business mailing address

316 E SILVER SPRING DR SUITE 238
MILWAUKEE WI
53217-5274
US

V. Phone/Fax

Practice location:
  • Phone: 414-332-6169
  • Fax: 414-332-6016
Mailing address:
  • Phone: 414-332-6169
  • Fax: 414-332-6016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number2946-015
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: