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General NPI Number Information
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NPI Number | 1336387687
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Entity Type | Individual
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Provider Name | DEANNA LISA BARRANCO D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 01/24/2009
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Last Update Date | 05/18/2011
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Provider Practice Location Address
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Address Line | 45 W 10TH ST SUITE LE
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City | NEW YORK
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State | NY
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Zip | 10011-8763
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Country | US
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Telephone | 212-982-5883
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Fax | 212-982-1504
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Provider Business Mailing Address
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Address Line | 1528 76TH ST
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City | BROOKLYN
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State | NY
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Zip | 11228-2504
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Country | US
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Telephone | 917-648-2913
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 054849
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22DI02417600
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License Number State | NJ
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