Healthcare Provider Details

I. General information

NPI: 1245716950
Provider Name (Legal Business Name): ERIK BALINGHASAY DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2018
Last Update Date: 05/03/2025
Certification Date: 05/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12750 CARMEL COUNTRY RD STE 201
SAN DIEGO CA
92130-2171
US

IV. Provider business mailing address

720 OLIVE WAY
SEATTLE WA
98101-1878
US

V. Phone/Fax

Practice location:
  • Phone: 626-384-6263
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number102623
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDE60793018
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: