Provider Demographics
NPI:1598807786
Name:BARRAMEDA, GINA FAIGAO (DMD)
Entity Type:Individual
Prefix:MRS
First Name:GINA
Middle Name:FAIGAO
Last Name:BARRAMEDA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8351 ROCHESTER AVE
Mailing Address - Street 2:STE 109
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730
Mailing Address - Country:US
Mailing Address - Phone:909-466-5352
Mailing Address - Fax:909-466-5357
Practice Address - Street 1:8351 ROCHESTER AVE
Practice Address - Street 2:STE 109
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730
Practice Address - Country:US
Practice Address - Phone:909-466-5352
Practice Address - Fax:909-466-5357
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA363621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice