Dan Terry Barnes Jr., D.M.D.

Individual provider Active NPI General Practice Dentistry · Branford, FL

NPI 1811026164 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1811026164
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DN 10874 (FL)
Practice address
110 Suwannee Ave SW
110 SW Suwannee Avenue
Branford, FL 32008-2749
Phone
(386) 935-0988
Fax
(386) 935-0989
NPI assigned
Mar 5, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DN 1040AKMDGeneral Practice Dentistry
DN 10874FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dan Terry Barnes DMD and Melissa Anderson-Barnes DMD PA General Practice Past Accepting new patients
Melanie L Kemmerer, DMD, PLLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN 10874 FL Yes
General Practice Dentistry 1223G0001X DN 1040 AK

Addresses

Primary practice location

110 Suwannee Ave SW
110 SW Suwannee Avenue
Branford, FL 32008-2749

Mailing address

PO Box 930
110 SW Suwannee Avenue
Branford, FL 32008-0930
Phone (386) 935-0988

Other identifiers

IdentifierTypeStateIssuer
DD 4603MedicaidAK

Other providers in Branford, FL

All providers in Branford, FL · General Practice Dentistry in Florida

Sources for this page

Verify at the official NPI Registry.