Provider Demographics
NPI:1124367933
Name:RUCHI NAGPAL DDS, PC
Entity Type:Organization
Organization Name:RUCHI NAGPAL DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:RUCHI
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGPAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:440-821-8990
Mailing Address - Street 1:555 W KINZIE ST
Mailing Address - Street 2:APT 1405
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-5727
Mailing Address - Country:US
Mailing Address - Phone:440-821-8990
Mailing Address - Fax:
Practice Address - Street 1:555 W KINZIE ST
Practice Address - Street 2:APT 1405
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-5727
Practice Address - Country:US
Practice Address - Phone:440-821-8990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-14
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019028451261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental