Provider Demographics
NPI:1679193858
Name:FAITH BARREYRO, DMD, INC.
Entity Type:Organization
Organization Name:FAITH BARREYRO, DMD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FAITH-ROSELLE
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:BARREYRO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:858-218-5188
Mailing Address - Street 1:8826 PAGODA WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-3322
Mailing Address - Country:US
Mailing Address - Phone:858-218-5188
Mailing Address - Fax:
Practice Address - Street 1:5425 OBERLIN DR STE 101
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1703
Practice Address - Country:US
Practice Address - Phone:858-546-0500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-17
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental