Provider Demographics
NPI:1831107622
Name:CHASE, BARRY N (DDS)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:N
Last Name:CHASE
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 1:560 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-5013
Mailing Address - Country:US
Mailing Address - Phone:516-506-0000
Mailing Address - Fax:516-822-4260
Practice Address - Street 1:324 S SERVICE RD
Practice Address - Street 2:SUITE 116
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-3270
Practice Address - Country:US
Practice Address - Phone:516-506-0000
Practice Address - Fax:516-822-4260
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032187-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist