Provider Demographics
NPI:1114130721
Name:BARABAS, AMARILDA (DDS)
Entity Type:Individual
Prefix:
First Name:AMARILDA
Middle Name:
Last Name:BARABAS
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 1:1322 PLYMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:ATWATER
Mailing Address - State:CA
Mailing Address - Zip Code:95301-9473
Mailing Address - Country:US
Mailing Address - Phone:209-357-3875
Mailing Address - Fax:209-358-7147
Practice Address - Street 1:2671 ALABAMA ST
Practice Address - Street 2:
Practice Address - City:ATWATER
Practice Address - State:CA
Practice Address - Zip Code:95301-2908
Practice Address - Country:US
Practice Address - Phone:209-358-7146
Practice Address - Fax:209-358-7147
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42803122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA42803OtherDDS LICENSE
CABB4638233OtherDEA