Provider Demographics
NPI:1568629640
Name:ARAO, BRENDA Y
Entity type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:Y
Last Name:ARAO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1970 E VISTA WAY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92084-3301
Mailing Address - Country:US
Mailing Address - Phone:760-724-0844
Mailing Address - Fax:
Practice Address - Street 1:1970 E VISTA WAY
Practice Address - Street 2:SUITE 202
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-3301
Practice Address - Country:US
Practice Address - Phone:760-724-0844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-17
Last Update Date:2008-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA395901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice