Ethan Benjamin Barkin

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

064638 Issued in NY

Practice address

625 Elmwood Ave # 683
Rochester, NY 14620-2913

Phone

(585) 275-5051

NPI assigned

Apr 26, 2022

Last updated

Aug 4, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1013651868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 EAST AVE APT 3R",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146103139",
            "telephone_number": "631-356-5129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 ELMWOOD AVE # 683",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146202913",
            "telephone_number": "585-275-5051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2081 W Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "14626",
            "country_code": "US",
            "telephone_number": "585-326-9961",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARKIN",
        "first_name": "ETHAN",
        "middle_name": "BENJAMIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-26",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "064638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bariatric & Gi Surgery of the University of Rochester
• Maria Barilla, LMHC
• Susan Maria Baritot, SLP
• Kimberly Barker, PT
• Samantha Barker, DPT
• Margaret Hannah Barlet, MD
• Daniel Paul Barletta, D.D.S.
• Karen Barletta, OTR/L
• Shikina Natasha Barley, RN
• Tiariqua Barlow, LPN

• Periodontics in Rochester, NY
• Providers in Rochester, NY by specialty
• Periodontics in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; 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.