Provider Demographics
NPI:1851792006
Name:BARRON WEISS, JEWEL (DDS)
Entity Type:Individual
Prefix:
First Name:JEWEL
Middle Name:
Last Name:BARRON WEISS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF
Mailing Address - State:NY
Mailing Address - Zip Code:10510-1559
Mailing Address - Country:US
Mailing Address - Phone:914-941-1890
Mailing Address - Fax:
Practice Address - Street 1:61 SUNSET DR
Practice Address - Street 2:
Practice Address - City:BRIARCLIFF
Practice Address - State:NY
Practice Address - Zip Code:10510-1559
Practice Address - Country:US
Practice Address - Phone:914-941-1890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042585122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist