Provider Demographics
NPI:1568658169
Name:RAMJI H BARAIYA D D S INC
Entity Type:Organization
Organization Name:RAMJI H BARAIYA D D S INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMJI
Authorized Official - Middle Name:H
Authorized Official - Last Name:BARAIYA
Authorized Official - Suffix:
Authorized Official - Credentials:D D S
Authorized Official - Phone:951-487-2644
Mailing Address - Street 1:PO BOX 1600
Mailing Address - Street 2:
Mailing Address - City:SAN JACINTO
Mailing Address - State:CA
Mailing Address - Zip Code:92581-1600
Mailing Address - Country:US
Mailing Address - Phone:951-487-2644
Mailing Address - Fax:951-487-2647
Practice Address - Street 1:1497 S SAN JACINTO AVE
Practice Address - Street 2:SUITE # B
Practice Address - City:SAN JACINTO
Practice Address - State:CA
Practice Address - Zip Code:92583-5105
Practice Address - Country:US
Practice Address - Phone:951-487-2644
Practice Address - Fax:951-487-2644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA407901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB 40790-01OtherDENTI-CAL(CALIFORNIA)