Healthcare Provider Details

I. General information

NPI: 1487735270
Provider Name (Legal Business Name): CARMELA BARINAGA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

906 NE GREENWOOD AVE
BEND OR
97701-4892
US

IV. Provider business mailing address

906 NE GREENWOOD AVE
BEND OR
97701-4892
US

V. Phone/Fax

Practice location:
  • Phone: 541-382-4848
  • Fax:
Mailing address:
  • Phone: 541-382-4848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD8101
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: