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General NPI Number Information
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NPI Number | 1356378350
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Entity Type | Individual
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Provider Name | DARA JEWELL BARRON DMD
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Gender | Female
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 08/09/2022
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Provider Practice Location Address
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Address Line | UNITED STATES PENITENTIARY ATLANTA, 601 MCDONOUGH BLVD SE
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City | ATLANTA
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State | GA
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Zip | 30315
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Country | US
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Telephone | 404-635-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 625 NINAS TRCE SW
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City | ATLANTA
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State | GA
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Zip | 30331-2039
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Country | US
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Telephone | 404-321-6111
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 10533
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 61891
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 010533
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License Number State | GA
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