Healthcare Provider Details

I. General information

NPI: 1073789707
Provider Name (Legal Business Name): PAULENCIA LAJOI MORRIS D.D.S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2008
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 MDG/SGDD 101 BODIN CIR
TRAVIS AFB CA
94535-1809
US

IV. Provider business mailing address

60 MDG/SGDD 101 BODIN CIR
TRAVIS AFB CA
94535-1809
US

V. Phone/Fax

Practice location:
  • Phone: 707-423-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number56882
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number56882
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: