Provider Demographics
NPI:1922210541
Name:BARAJAS, ERIC BRYAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:BRYAN
Last Name:BARAJAS
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 1:890 EASTLAKE PARKWAY
Mailing Address - Street 2:SUITE 304
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91914
Mailing Address - Country:US
Mailing Address - Phone:619-482-7367
Mailing Address - Fax:619-591-7038
Practice Address - Street 1:890 EASTLAKE PARKWAY
Practice Address - Street 2:SUITE 304
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914
Practice Address - Country:US
Practice Address - Phone:619-482-7367
Practice Address - Fax:619-591-7038
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32532122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist