Provider Demographics
NPI:1679987713
Name:BARNHART, JUSTIN
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:
Last Name:BARNHART
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3008 GARDEN GROVE PKWY
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-4216
Mailing Address - Country:US
Mailing Address - Phone:620-669-0835
Mailing Address - Fax:620-669-8740
Practice Address - Street 1:3008 GARDEN GROVE PKWY
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-4216
Practice Address - Country:US
Practice Address - Phone:620-669-0835
Practice Address - Fax:620-669-8740
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-17
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS60991122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist