Provider Demographics
NPI:1730442286
Name:KENNETH C. BARNEY DDS INC
Entity type:Organization
Organization Name:KENNETH C. BARNEY DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:BARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:304-754-8803
Mailing Address - Street 1:101 N MARY ST.
Mailing Address - Street 2:
Mailing Address - City:HEDGESVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25427-6984
Mailing Address - Country:US
Mailing Address - Phone:304-754-8803
Mailing Address - Fax:304-754-8039
Practice Address - Street 1:101 NORTH MARY ST.
Practice Address - Street 2:
Practice Address - City:HEDGESVILLE
Practice Address - State:WV
Practice Address - Zip Code:25427-6984
Practice Address - Country:US
Practice Address - Phone:304-754-8803
Practice Address - Fax:304-754-8039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-20
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2665332BC3200X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty