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General NPI Number Information
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NPI Number | 1932302486
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Entity Type | Individual
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Provider Name | SHANNON KATHARINE BARNHART DDS
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Gender | Female
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 03/17/2013
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Provider Practice Location Address
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Address Line | 4700 LAS VEGAS BLVD N 99TH DENTAL SQUADRON- MOFMC
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City | NELLIS AFB
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State | NV
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Zip | 89191-6600
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Country | US
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Telephone | 702-653-2761
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Fax |
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Provider Business Mailing Address
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Address Line | 11437 VALENTINO LN
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City | LAS VEGAS
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State | NV
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Zip | 89138-7572
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Country | US
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Telephone | 702-478-5504
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 21091
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 61785
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License Number State | CA
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