Provider Demographics
NPI:1316091705
Name:MYERS, BARRY S (DDS)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:S
Last Name:MYERS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 HICKSVILLE ROAD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-5819
Mailing Address - Country:US
Mailing Address - Phone:516-798-8855
Mailing Address - Fax:516-798-8859
Practice Address - Street 1:20 HICKSVILLE ROAD
Practice Address - Street 2:SUITE 8
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-5819
Practice Address - Country:US
Practice Address - Phone:516-798-8855
Practice Address - Fax:516-798-8859
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0295561223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics