Provider Demographics
NPI:1386736254
Name:BARENBAUM, POLINA (DDS)
Entity type:Individual
Prefix:DR
First Name:POLINA
Middle Name:
Last Name:BARENBAUM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 LERNARD RD
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-7912
Mailing Address - Country:US
Mailing Address - Phone:732-252-5973
Mailing Address - Fax:732-780-4707
Practice Address - Street 1:3585 ROUTE 9 NORTH
Practice Address - Street 2:SUITE 57
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728
Practice Address - Country:US
Practice Address - Phone:732-780-7222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI022172001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice