Provider Demographics
NPI:1265124655
Name:BARRERA, JAIRO ROLANDO (DMD)
Entity type:Individual
Prefix:DR
First Name:JAIRO
Middle Name:ROLANDO
Last Name:BARRERA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 MCGEE DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-2530
Mailing Address - Country:US
Mailing Address - Phone:775-971-8080
Mailing Address - Fax:
Practice Address - Street 1:735 SPARKS BLVD
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434-7930
Practice Address - Country:US
Practice Address - Phone:775-359-3934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program