John E. Barroso, DDS
Individual provider Active NPI Dentist · Burleson, TX
NPI 1396889754 · NPPES record last updated May 21, 2015
Key facts
- NPI
- 1396889754
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 12789 (TX)
- Practice address
- 101 NW Renfro St
Suite 104
Burleson, TX 76028-4111 - Phone
- (817) 447-6040
- Fax
- (817) 447-6004
- NPI assigned
- Feb 19, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231220003481 | TX | Order and Referring Only - Dentist |
7214258631 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12789 | TX | MD | Dental Hygienist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12789 | TX | Yes |
Addresses
Primary practice location
101 NW Renfro St
Suite 104
Burleson, TX 76028-4111
Mailing address
101 NW Renfro St
Suite 104
Burleson, TX 76028-4111
Phone (817) 447-6040
Other providers in Burleson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.