Chad John Barney, D.M.D.

Individual provider Active NPI General Practice Dentistry · Lewiston, ID

NPI 1063529337 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1063529337
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
D-3147 (ID)
Practice address
328 Saint Johns Way
Lewiston, ID 83501-2451
Phone
(208) 746-1771
Fax
(208) 798-1586
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20141209000452 ID Order and Referring Only - Oral Surgery
Practitioner - Oral Surgery
7810219516

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D-3147 ID Yes

Addresses

Primary practice location

328 Saint Johns Way
Lewiston, ID 83501-2451

Mailing address

611 25TH Ave
Lewiston, ID 83501-3851
Phone (208) 798-8907

Other providers in Lewiston, ID

All providers in Lewiston, ID · General Practice Dentistry in Idaho

Sources for this page

Verify at the official NPI Registry.