Provider Demographics
NPI:1831864446
Name:LIRA, ERIKA P
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:P
Last Name:LIRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2497 HERNDON AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-8977
Mailing Address - Country:US
Mailing Address - Phone:559-293-4942
Mailing Address - Fax:
Practice Address - Street 1:2497 HERNDON AVE STE 104
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-8977
Practice Address - Country:US
Practice Address - Phone:559-293-4942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant