MEDICARE: DR. NAOMI RUTH BARIUAN 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	DN0013032	FL

General Provider Information

NPI Number	:	1134280183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NAOMI RUTH BARIUAN DDS

Provider Business Mailing Address
First Line	:	6144 GAZEBO PARK PL S
Second Line	:	#210
City	:	JACKSONVILLE
State	:	FL
Zip	:	32257-1099
Country	:	US
Telephone Number	:	904-262-9466
Fax Number	:	904-268-8648

Provider Business Practice Location Address
First Line	:	6144 GAZEBO PARK PL S
Second Line	:	#210
City	:	JACKSONVILLE
State	:	FL
Zip	:	32257-1099
Country	:	US
Telephone Number	:	904-262-9466
Fax Number	:	904-268-8648

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

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	06/05/2008

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