Provider Demographics
NPI:1386781532
Name:KIRSCHNER, BARRY STEPHAN (DDS)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:STEPHAN
Last Name:KIRSCHNER
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 1:7161 W PLANADA LN
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85310-5875
Mailing Address - Country:US
Mailing Address - Phone:623-561-0138
Mailing Address - Fax:
Practice Address - Street 1:13576 W CAMINO DEL SOL
Practice Address - Street 2:SUITE 21
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-4425
Practice Address - Country:US
Practice Address - Phone:623-584-6331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ31771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice