Provider Demographics
NPI:1295102911
Name:BARONE, RICHARD (DDS)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:BARONE
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 1:1122 E LINCOLN AVE STE 114
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92865-1908
Mailing Address - Country:US
Mailing Address - Phone:714-637-5222
Mailing Address - Fax:714-637-7475
Practice Address - Street 1:1122 E LINCOLN AVE STE 114
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92865-1908
Practice Address - Country:US
Practice Address - Phone:714-637-5222
Practice Address - Fax:714-637-7475
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36225122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist