Provider Demographics
NPI:1942303425
Name:BARRY, RICHARD BERNARD (DDS)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:BERNARD
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 1:1234 OLD HENDERSON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220
Mailing Address - Country:US
Mailing Address - Phone:614-451-2234
Mailing Address - Fax:614-451-1511
Practice Address - Street 1:1234 OLD HENDERSON RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220
Practice Address - Country:US
Practice Address - Phone:614-451-2234
Practice Address - Fax:614-451-1511
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH16389122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHBA4033111Medicaid
OHBA4033111Medicaid