Provider Demographics
NPI:1538666821
Name:BARRIERE, TONY CHRISTIANSON (DDS)
Entity Type:Individual
Prefix:DR
First Name:TONY
Middle Name:CHRISTIANSON
Last Name:BARRIERE
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 1:3610 WESTFALL DR
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-4154
Mailing Address - Country:US
Mailing Address - Phone:818-625-0736
Mailing Address - Fax:
Practice Address - Street 1:12301 WILSHIRE BLVD STE 205
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1051
Practice Address - Country:US
Practice Address - Phone:310-481-0111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-12
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1044521223G0001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program