Provider Demographics
NPI:1699817866
Name:GINA FAIGAO BARRAMEDA DMD INC
Entity Type:Organization
Organization Name:GINA FAIGAO BARRAMEDA DMD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:FAIGAO
Authorized Official - Last Name:BARRAMEDA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:909-466-5352
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:91739
Mailing Address - Country:US
Mailing Address - Phone:909-466-5351
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:909-466-5351
Practice Address - Fax:909-466-5357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty