Provider Demographics
NPI:1982818175
Name:VILKIN, BARRY MICHAEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:MICHAEL
Last Name:VILKIN
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 1:5363 BALBOA BLVD # 528A
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-2805
Mailing Address - Country:US
Mailing Address - Phone:747-208-8668
Mailing Address - Fax:818-788-1288
Practice Address - Street 1:5363 BALBOA BLVD # 528A
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-2805
Practice Address - Country:US
Practice Address - Phone:747-208-8668
Practice Address - Fax:818-788-1288
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0324101223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics