Provider Demographics
NPI:1265456487
Name:WEISS, IRA HAROLD (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:IRA
Middle Name:HAROLD
Last Name:WEISS
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3755 ORANGE PL
Mailing Address - Street 2:SUITE 100A
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4426
Mailing Address - Country:US
Mailing Address - Phone:216-292-6340
Mailing Address - Fax:440-885-1911
Practice Address - Street 1:3755 ORANGE PL
Practice Address - Street 2:SUITE 100A
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4426
Practice Address - Country:US
Practice Address - Phone:216-292-6340
Practice Address - Fax:440-885-1911
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH300168081223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics