Provider Demographics
NPI:1295816031
Name:ISRAEL, BARRY DEAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:DEAN
Last Name:ISRAEL
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 1:10861 CHERRY ST
Mailing Address - Street 2:304
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-5402
Mailing Address - Country:US
Mailing Address - Phone:562-430-3998
Mailing Address - Fax:562-430-7236
Practice Address - Street 1:10861 CHERRY ST
Practice Address - Street 2:304
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-5402
Practice Address - Country:US
Practice Address - Phone:562-430-3998
Practice Address - Fax:562-430-7236
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0323251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice