Mark K Barone, D.D.S.

Individual provider Active NPI General Practice Dentistry · Warsaw, NY

NPI 1689798209 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1689798209
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
039467-1 (NY)
Practice address
34 Duncan St
Warsaw, NY 14569-1017
Phone
(585) 786-3676
Fax
(585) 786-3896
NPI assigned
Mar 19, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20140811000154 NY Order and Referring Only - Oral Surgery
Practitioner - Oral Surgery
2668643628

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
039467-1NYMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 039467-1 NY Yes

Addresses

Primary practice location

34 Duncan St
Warsaw, NY 14569-1017

Mailing address

34 Duncan St
Warsaw, NY 14569-1017
Phone (585) 786-3676

Other identifiers

IdentifierTypeStateIssuer
161350913OtherNYCORP TAX ID#
00934047MedicaidNY

Other providers in Warsaw, NY

All providers in Warsaw, NY · General Practice Dentistry in New York

Sources for this page

Verify at the official NPI Registry.