Provider Demographics
NPI:1154619153
Name:LLANES, BARBARA IRASEMA (DMD)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:IRASEMA
Last Name:LLANES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7305 SW 142ND CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-2961
Mailing Address - Country:US
Mailing Address - Phone:305-335-9615
Mailing Address - Fax:
Practice Address - Street 1:747 PONCE DE LEON BLVD STE 609
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2074
Practice Address - Country:US
Practice Address - Phone:305-448-7217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-12
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN194541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice