Provider Demographics
NPI:1780084806
Name:ABRAHAM, ERINI (DDS)
Entity type:Individual
Prefix:DR
First Name:ERINI
Middle Name:
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8206 LAUREL RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92508-3529
Mailing Address - Country:US
Mailing Address - Phone:951-333-1351
Mailing Address - Fax:951-656-2650
Practice Address - Street 1:32065 TEMECULA PKWY STE C
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-6806
Practice Address - Country:US
Practice Address - Phone:951-302-9300
Practice Address - Fax:951-303-9300
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA634371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice