Provider Demographics
NPI:1609013366
Name:SAMARAJ, JAYAPRIYA (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAYAPRIYA
Middle Name:
Last Name:SAMARAJ
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 1:3640 CLAYTON RD
Mailing Address - Street 2:APT 102
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-5188
Mailing Address - Country:US
Mailing Address - Phone:925-429-0482
Mailing Address - Fax:
Practice Address - Street 1:3640 CLAYTON RD
Practice Address - Street 2:APT 102
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94521-5188
Practice Address - Country:US
Practice Address - Phone:925-429-0482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA573271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice