Provider Demographics
NPI:1679533988
Name:BARTH, CHAD J (DDS)
Entity type:Individual
Prefix:DR
First Name:CHAD
Middle Name:J
Last Name:BARTH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E RED BRIDGE RD
Mailing Address - Street 2:#120
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-4035
Mailing Address - Country:US
Mailing Address - Phone:816-769-5281
Mailing Address - Fax:816-942-8669
Practice Address - Street 1:400 E RED BRIDGE RD
Practice Address - Street 2:#120
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-4035
Practice Address - Country:US
Practice Address - Phone:816-769-5281
Practice Address - Fax:816-942-8669
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO27752122300000X
KS602791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice