Provider Demographics
NPI:1295731222
Name:BIRON, ROLAND TIKO (MD, DMD)
Entity type:Individual
Prefix:MR
First Name:ROLAND
Middle Name:TIKO
Last Name:BIRON
Suffix:
Gender:M
Credentials:MD, DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 MCGINLEY ALY
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-4507
Mailing Address - Country:US
Mailing Address - Phone:215-350-8732
Mailing Address - Fax:215-701-7509
Practice Address - Street 1:219 NORTH SYCAMORE STREET
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940
Practice Address - Country:US
Practice Address - Phone:215-579-9900
Practice Address - Fax:215-701-7509
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ059621223S0112X
RIDEN029141223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
RICDEN02914OtherRX PRIVILEGES
MA21512OtherDENTAL LICENSE
RIDEN02914OtherDENTAL LICENSE
RIDAPA02662OtherANESTHESIA PERMIT
RIMD12149OtherMEDICAL LICENSE
RIDAPA02662OtherANESTHESIA PERMIT
RIDEN02914OtherDENTAL LICENSE