Provider Demographics
NPI:1831219039
Name:LAZAR, BARRY RICHARD (DDS)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:RICHARD
Last Name:LAZAR
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 1:1591 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-3570
Mailing Address - Country:US
Mailing Address - Phone:216-521-1985
Mailing Address - Fax:
Practice Address - Street 1:4320 MAYFIELD RD
Practice Address - Street 2:SUITE 105
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-3661
Practice Address - Country:US
Practice Address - Phone:216-291-2080
Practice Address - Fax:216-381-2229
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.018651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice