MEDICARE: JANET C. BARRESI 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	4571	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1346233343	OTHER	OK	NPI

General Provider Information

NPI Number	:	1285808196
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JANET C. BARRESI DDS

Provider Business Mailing Address
First Line	:	11016 QUAIL CREEK RD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-6207
Country	:	US
Telephone Number	:	405-755-9014
Fax Number	:

Provider Business Practice Location Address
First Line	:	11016 QUAIL CREEK RD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-6207
Country	:	US
Telephone Number	:	405-755-9014
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JANET C. BARRESI
Credential	:	DDS
Telephone Number	:	405-755-9014

Provider Enumeration Date	:	04/22/2008
Last Update Date	:	04/22/2008

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