Provider Demographics
NPI:1245716620
Name:IVETA IONTCHEVA-BAREHMI DMD, PC
Entity type:Organization
Organization Name:IVETA IONTCHEVA-BAREHMI DMD, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IVETA
Authorized Official - Middle Name:
Authorized Official - Last Name:IONTCHEVA-BAREHMI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS, DSC,
Authorized Official - Phone:617-868-1516
Mailing Address - Street 1:1842 BEACON ST STE 305
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-1922
Mailing Address - Country:US
Mailing Address - Phone:617-868-1516
Mailing Address - Fax:
Practice Address - Street 1:1842 BEACON ST STE 305
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-1922
Practice Address - Country:US
Practice Address - Phone:617-868-1516
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-18
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20930261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental