Jonah Alexander Barasz, D.M.D
Individual provider Active NPI Dentist · Meriden, CT
NPI 1669769550 · NPPES record last updated Dec 11, 2021
Key facts
- NPI
- 1669769550
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 10619 (CT)
- Practice address
- 546 S Broad St Ste 2D
Meriden, CT 06450-6601 - Phone
- (203) 630-1312
- NPI assigned
- Jun 30, 2011
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10619 | CT | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 10619 | CT | Yes |
Addresses
Primary practice location
546 S Broad St Ste 2D
Meriden, CT 06450-6601
Mailing address
546 S Broad St Ste 2D
Meriden, CT 06450-6601
Phone (203) 630-1312
Other providers in Meriden, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 11, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.