Provider Demographics
NPI:1932313301
Name:KAHANE, BARRY A (DMD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:A
Last Name:KAHANE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16434 73RD AVE
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366-1242
Mailing Address - Country:US
Mailing Address - Phone:718-969-2237
Mailing Address - Fax:718-575-3874
Practice Address - Street 1:11301 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5555
Practice Address - Country:US
Practice Address - Phone:718-575-1238
Practice Address - Fax:718-575-3874
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04259991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice