Provider Demographics
NPI:1073838512
Name:FELDMAN, BARRY ELLIOT (DDS)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:ELLIOT
Last Name:FELDMAN
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 1:152 ROLLINS AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4008
Mailing Address - Country:US
Mailing Address - Phone:301-468-1555
Mailing Address - Fax:301-468-1876
Practice Address - Street 1:152 ROLLINS AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4008
Practice Address - Country:US
Practice Address - Phone:301-468-1555
Practice Address - Fax:301-468-1876
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-27
Last Update Date:2010-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD3898122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist