Provider Demographics
NPI:1750584116
Name:BARRETT, KATHLEEN F (DDS)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:F
Last Name:BARRETT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 LONGBROOK WAY STE 16
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-2429
Mailing Address - Country:US
Mailing Address - Phone:925-682-1312
Mailing Address - Fax:925-682-6118
Practice Address - Street 1:100 LONGBROOK WAY STE 16
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-2429
Practice Address - Country:US
Practice Address - Phone:925-682-1312
Practice Address - Fax:925-682-6118
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD310331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice