Provider Demographics
NPI:1881873875
Name:BARCESSAT, JESSICA (DMD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:BARCESSAT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2090 7TH AVE
Mailing Address - Street 2:GROUND FLOOR- DENTAL OFFICE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-4990
Mailing Address - Country:US
Mailing Address - Phone:212-749-2222
Mailing Address - Fax:212-749-2220
Practice Address - Street 1:2090 7TH AVE
Practice Address - Street 2:GROUND FLOOR - DENTAL OFFICE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-4990
Practice Address - Country:US
Practice Address - Phone:212-749-2222
Practice Address - Fax:212-749-2220
Is Sole Proprietor?:No
Enumeration Date:2007-10-26
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054774-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice