Provider Demographics
NPI:1841393808
Name:HERMAN, BARRY ALAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:ALAN
Last Name:HERMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:BARRY
Other - Middle Name:A
Other - Last Name:HERMAN DDS INC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:18740 VENTURA BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-6309
Mailing Address - Country:US
Mailing Address - Phone:818-342-3133
Mailing Address - Fax:
Practice Address - Street 1:18740 VENTURA BLVD STE 203
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-6309
Practice Address - Country:US
Practice Address - Phone:818-342-3133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA213131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice