MEDICARE: DR. BRETT M BARNEY DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	5038	AZ
2	1223E0200X	Endodontics	5038	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	100-5038	OTHER	AZ	DELTA DENTAL
2	AZ 0490680	OTHER	AZ	BLUECROSS BLUESHIELD

General Provider Information

NPI Number	:	1104812775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRETT M BARNEY DDS

Provider Business Mailing Address
First Line	:	8265 S HOUGHTON RD
Second Line	:	SUITE 101
City	:	TUCSON
State	:	AZ
Zip	:	85747-9702
Country	:	US
Telephone Number	:	520-663-0419
Fax Number	:	520-663-0429

Provider Business Practice Location Address
First Line	:	8265 S HOUGHTON RD
Second Line	:	SUITE 101
City	:	TUCSON
State	:	AZ
Zip	:	85747-9702
Country	:	US
Telephone Number	:	520-663-0419
Fax Number	:	520-663-0429

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	11/02/2021

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