Provider Demographics
NPI:1184164295
Name:BARRETT, TIFFANY (DDS)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:BARRETT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:
Other - Last Name:CHUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1100 POYDRAS ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70163-1101
Mailing Address - Country:US
Mailing Address - Phone:504-527-9952
Mailing Address - Fax:504-527-9950
Practice Address - Street 1:200 HENRY CLAY AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-5798
Practice Address - Country:US
Practice Address - Phone:504-899-9511
Practice Address - Fax:504-896-9707
Is Sole Proprietor?:No
Enumeration Date:2017-03-08
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA75911223P0221X
CA102195122300000X
TX348381223P0221X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program