Individual provider Active NPI

Reza Michael Barry, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Tallahassee, FL
National Provider Identifier
1003229899
Registry record updated Apr 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DN20885 Issued in FL
Practice address
3051 Highland Oaks Ter
Suite 4
Tallahassee, FL 32301-3845
Phone
(850) 656-3917
NPI assigned
Jun 9, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DN20885 FL Primary

Addresses

Primary practice location

3051 Highland Oaks Ter
Suite 4
Tallahassee, FL 32301-3845

Mailing address

3909 Reserve Dr
Apt 2623
Tallahassee, FL 32311-8200
Phone (850) 241-2868

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN20885FLMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493251200000",
    "number": "1003229899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3909 RESERVE DR",
            "address_2": "APT 2623",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323118200",
            "telephone_number": "850-241-2868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3051 HIGHLAND OAKS TER",
            "address_2": "SUITE 4",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323013845",
            "telephone_number": "850-656-3917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRY",
        "first_name": "REZA",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-09",
        "last_updated": "2017-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "DN20885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.