Provider Demographics
NPI:1205295862
Name:BATEMAN, GABRIELLA MARIE ORONA (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:GABRIELLA
Middle Name:MARIE ORONA
Last Name:BATEMAN
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 SAN MATEO RD
Mailing Address - Street 2:# 104
Mailing Address - City:HALF MOON BAY
Mailing Address - State:CA
Mailing Address - Zip Code:94019-7111
Mailing Address - Country:US
Mailing Address - Phone:650-726-2144
Mailing Address - Fax:
Practice Address - Street 1:210 SAN MATEO RD
Practice Address - Street 2:# 104
Practice Address - City:HALF MOON BAY
Practice Address - State:CA
Practice Address - Zip Code:94019-7111
Practice Address - Country:US
Practice Address - Phone:650-726-2144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-11
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101980122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist