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General NPI Number Information
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NPI Number | 1265124655
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Entity Type | Individual
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Provider Name | JAIRO ROLANDO BARRERA DMD
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Gender | Male
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Dates
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Enumeration Date | 05/23/2023
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Last Update Date | 05/23/2023
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Provider Practice Location Address
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Address Line | 735 SPARKS BLVD
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City | SPARKS
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State | NV
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Zip | 89434-7930
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Country | US
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Telephone | 775-359-3934
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Fax |
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Provider Business Mailing Address
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Address Line | 1090 MCGEE DR
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City | RENO
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State | NV
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Zip | 89523-2530
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Country | US
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Telephone | 775-971-8080
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | NV
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