Provider Demographics
NPI:1366670556
Name:BARRONER, MEGHAN DEISROTH (DMD)
Entity Type:Individual
Prefix:DR
First Name:MEGHAN
Middle Name:DEISROTH
Last Name:BARRONER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:MISS
Other - First Name:MEGHAN
Other - Middle Name:DEISROTH
Other - Last Name:BEERBOWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:1131 BOYCE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:UPPER ST CLAIR
Mailing Address - State:PA
Mailing Address - Zip Code:15241-3927
Mailing Address - Country:US
Mailing Address - Phone:724-260-5009
Mailing Address - Fax:724-299-3154
Practice Address - Street 1:1131 BOYCE RD
Practice Address - Street 2:SUITE A
Practice Address - City:UPPER ST CLAIR
Practice Address - State:PA
Practice Address - Zip Code:15241-3927
Practice Address - Country:US
Practice Address - Phone:724-260-5009
Practice Address - Fax:724-299-3154
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-25
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS039001122300000X, 1223S0112X, 204E00000X
PADA031706207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery