Provider Demographics
NPI:1194254425
Name:PARRA BARILLAS, ADRIANA MARIA (DDS)
Entity type:Individual
Prefix:
First Name:ADRIANA
Middle Name:MARIA
Last Name:PARRA BARILLAS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ADRIANA
Other - Middle Name:MARIA
Other - Last Name:PARRA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:45 HINTERLANDS DR.
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572
Mailing Address - Country:US
Mailing Address - Phone:585-642-3530
Mailing Address - Fax:
Practice Address - Street 1:625 ELMWOOD AVE # 683
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-2913
Practice Address - Country:US
Practice Address - Phone:585-275-8315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY060714122300000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program