Provider Demographics
NPI:1477027654
Name:MALDONADO BARRIOS, DANIELLA ALCIRA
Entity Type:Individual
Prefix:
First Name:DANIELLA
Middle Name:ALCIRA
Last Name:MALDONADO BARRIOS
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:DANIELLA
Other - Middle Name:ALCIRA
Other - Last Name:MALDONADO BARRIOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5300 DUNSMUIR RD APT 6
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-8525
Mailing Address - Country:US
Mailing Address - Phone:661-563-2699
Mailing Address - Fax:
Practice Address - Street 1:1625 S H ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304-4931
Practice Address - Country:US
Practice Address - Phone:661-398-1744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-22
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103448122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist