Provider Demographics
NPI:1346479938
Name:BARIKBIN, MARIAM (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARIAM
Middle Name:
Last Name:BARIKBIN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:MARIAM
Other - Middle Name:
Other - Last Name:GUDARZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:101 DORCHESTER WAY
Mailing Address - Street 2:
Mailing Address - City:HARLEYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19438-2998
Mailing Address - Country:US
Mailing Address - Phone:276-273-2484
Mailing Address - Fax:
Practice Address - Street 1:101 DORCHESTER WAY
Practice Address - Street 2:
Practice Address - City:HARLEYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19438-2998
Practice Address - Country:US
Practice Address - Phone:276-273-2484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS037939122300000X
FLDN18272122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist