NPIMap

Barry I Stark, D.D.S.

Individual provider Active NPI General Practice Dentistry · North Branford, CT

NPI 1376664680 · NPPES record last updated Jun 5, 2013

Key facts

NPI
1376664680
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
4258 (CT)
Practice address
337 Notch Hill Rd
North Branford, CT 06471-1826
Phone
(203) 488-6343
Fax
(203) 488-6185
NPI assigned
Apr 3, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4258CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
North Branford Dental Group PC General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4258 CT Yes

Addresses

Primary practice location

337 Notch Hill Rd
North Branford, CT 06471-1826

Mailing address

PO Box 193
North Branford, CT 06471-0193
Phone (204) 488-6343

Other providers in North Branford, CT

All providers in North Branford, CT · General Practice Dentistry in Connecticut

Sources for this page

Verify at the official NPI Registry.