MEDICARE: DR. TONY CHRISTIANSON BARRIERE DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	104452	CA
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1538666821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TONY CHRISTIANSON BARRIERE DDS

Provider Business Mailing Address
First Line	:	3610 WESTFALL DR
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91436-4154
Country	:	US
Telephone Number	:	818-625-0736
Fax Number	:

Provider Business Practice Location Address
First Line	:	12301 WILSHIRE BLVD STE 205
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-1051
Country	:	US
Telephone Number	:	310-481-0111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2018
Last Update Date	:	04/28/2020

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