Provider Demographics
NPI:1275894586
Name:BARRY SHIPMAN DMD, PA
Entity Type:Organization
Organization Name:BARRY SHIPMAN DMD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDEENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:305-864-5557
Mailing Address - Street 1:10180 W BAY HARBOR DR
Mailing Address - Street 2:5 C
Mailing Address - City:BAY HARBOR ISLANDS
Mailing Address - State:FL
Mailing Address - Zip Code:33154-1292
Mailing Address - Country:US
Mailing Address - Phone:305-864-5557
Mailing Address - Fax:
Practice Address - Street 1:951 NE 167TH ST
Practice Address - Street 2:208
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-3711
Practice Address - Country:US
Practice Address - Phone:305-864-5557
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-04
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN50561223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty