Debra Jean Araujo, DDS

Individual provider Active NPI General Practice Dentistry · Sausalito, CA

NPI 1003959792 · NPPES record last updated Feb 22, 2012

Key facts

NPI
1003959792
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
44654 (CA)
Practice address
630 Drake Ave
Sausalito, CA 94965-1107
Phone
(415) 339-8813
Fax
(415) 339-8814
NPI assigned
Feb 14, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
44654CAMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 44654 CA Yes

Addresses

Primary practice location

630 Drake Ave
Sausalito, CA 94965-1107

Mailing address

630 Drake Ave
Sausalito, CA 94965-1107
Phone (415) 339-8813

Other identifiers

IdentifierTypeStateIssuer
FHC70957FMedicaidCA
1598786352MedicaidCA
FHC03887FMedicaidCA

Other providers in Sausalito, CA

All providers in Sausalito, CA · General Practice Dentistry in California

Sources for this page

Verify at the official NPI Registry.