Provider Demographics
NPI:1003448903
Name:GINITHAN, ERIN RACHEL (RDH)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:RACHEL
Last Name:GINITHAN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13451 BRADFORD ST
Mailing Address - Street 2:
Mailing Address - City:HORIZON CITY
Mailing Address - State:TX
Mailing Address - Zip Code:79928-7343
Mailing Address - Country:US
Mailing Address - Phone:915-433-8331
Mailing Address - Fax:
Practice Address - Street 1:1816 N ZARAGOZA RD STE B
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-8019
Practice Address - Country:US
Practice Address - Phone:915-433-8331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-08
Last Update Date:2020-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18636124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist