Individual provider Active NPI

Kevin W Barnhart, DDS ORAL & MAXILLOFA

  • Oral and Maxillofacial Surgery (Dentist)
  • San Diego, CA
National Provider Identifier
1922197128
Registry record updated Feb 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
54379 Issued in CA
Practice address
12395 El Camino Real
Suite 304
San Diego, CA 92130-3082
Phone
(858) 793-3393
Fax
(858) 793-3383
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 54379 CA Primary

Addresses

Primary practice location

12395 El Camino Real
Suite 304
San Diego, CA 92130-3082

Mailing address

12395 El Camino Real
Suite 304
San Diego, CA 92130-3082
Phone (858) 793-3393

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
54379CAMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329782400000",
    "number": "1922197128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12395 EL CAMINO REAL",
            "address_2": "SUITE 304",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921303082",
            "telephone_number": "858-793-3393",
            "fax_number": "858-793-3383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12395 EL CAMINO REAL",
            "address_2": "SUITE 304",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921303082",
            "telephone_number": "858-793-3393",
            "fax_number": "858-793-3383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNHART",
        "first_name": "KEVIN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DDS ORAL & MAXILLOFA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2012-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "54379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.