Provider Demographics
NPI:1043078140
Name:BARRIOS, DIONELIS JAELISSE
Entity type:Individual
Prefix:
First Name:DIONELIS
Middle Name:JAELISSE
Last Name:BARRIOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DIONELIS
Other - Middle Name:JAELISSE
Other - Last Name:SANCHEZ JIMENEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:812 BLUE FISH RD
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-5394
Mailing Address - Country:US
Mailing Address - Phone:305-401-9352
Mailing Address - Fax:305-401-9351
Practice Address - Street 1:921 NE 13TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5007
Practice Address - Country:US
Practice Address - Phone:305-401-9351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant