Provider Demographics
NPI:1174780456
Name:BARNES, SARA I (RDH)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:I
Last Name:BARNES
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 OSPREY CIR
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:GA
Mailing Address - Zip Code:31558-4102
Mailing Address - Country:US
Mailing Address - Phone:912-573-4212
Mailing Address - Fax:912-573-2035
Practice Address - Street 1:217 OSPREY CIR
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558-4102
Practice Address - Country:US
Practice Address - Phone:912-729-3012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADH001571124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GADH001571OtherREGISTERED DENTAL HYGIENIST