Provider Demographics
NPI:1811168859
Name:FERREIRA, DIAMANTINO (DDS)
Entity type:Individual
Prefix:
First Name:DIAMANTINO
Middle Name:
Last Name:FERREIRA
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 1:1537 ROSECRANS ST STE C
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92106-2280
Mailing Address - Country:US
Mailing Address - Phone:619-223-1606
Mailing Address - Fax:619-795-6094
Practice Address - Street 1:1537 ROSECRANS ST STE C
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92106-2280
Practice Address - Country:US
Practice Address - Phone:619-223-1606
Practice Address - Fax:619-795-6094
Is Sole Proprietor?:No
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA357191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice