Provider Demographics
NPI:1598812737
Name:BARAIYA, RAMJIBHAI H (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAMJIBHAI
Middle Name:H
Last Name:BARAIYA
Suffix:
Gender:M
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: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:951-487-2647
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40790122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB40790OtherDENTI-CAL