Provider Demographics
NPI:1598751950
Name:BARRY, JOSEPH P (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:P
Last Name:BARRY
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 1:685 GRACELAND AVE
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-4518
Mailing Address - Country:US
Mailing Address - Phone:847-824-3536
Mailing Address - Fax:847-824-2783
Practice Address - Street 1:685 GRACELAND AVE
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-4518
Practice Address - Country:US
Practice Address - Phone:847-824-3536
Practice Address - Fax:847-824-2783
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0171151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice