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General NPI Number Information
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NPI Number | 1558288233
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Entity Type | Individual
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Provider Name | BRIANNA BALTAZAR-MARTINEZ RDA
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Gender | Female
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Dates
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Enumeration Date | 07/02/2026
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Last Update Date | 07/02/2026
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Provider Practice Location Address
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Address Line | 500 S CHINOWTH ST STE 201
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City | VISALIA
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State | CA
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Zip | 93277-1653
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Country | US
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Telephone | 559-624-1177
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Fax |
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Provider Business Mailing Address
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Address Line | 2431 W CLINTON AVE
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City | VISALIA
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State | CA
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Zip | 93291-3137
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Country | US
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Telephone | 559-616-0430
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 63101
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License Number State | CA
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