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NPI Code Detail

MEDICARE: VIVIAN BARRON DDS

MEDICARE: VIVIAN BARRON 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
11223G0001XGeneral Practice DentistryDN1858001MA

General Provider Information

NPI Number : 1659866135
Entity Type Code : Individual
Provider Name (Legal Business Name) : VIVIAN BARRON DDS
Provider Business Mailing Address
First Line : 1008 MASSACHUSETTS AVE APT 605
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02138-5353
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1096 REVERE BEACH PKWY
Second Line :
City : CHELSEA
State : MA
Zip : 02150-1454
Country : US
Telephone Number : 856-776-7658
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2018
Last Update Date : 06/26/2018

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