Provider Demographics
NPI:1952743320
Name:BARRON, RANDI C (DDS)
Entity Type:Individual
Prefix:
First Name:RANDI
Middle Name:C
Last Name:BARRON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 E 69TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5000
Mailing Address - Country:US
Mailing Address - Phone:212-772-3201
Mailing Address - Fax:212-772-3878
Practice Address - Street 1:129 E 69TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5000
Practice Address - Country:US
Practice Address - Phone:212-772-3201
Practice Address - Fax:212-772-3878
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY37655122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist