Provider Demographics
NPI:1245418227
Name:RAYANI, DIMPLE (DMD)
Entity Type:Individual
Prefix:
First Name:DIMPLE
Middle Name:
Last Name:RAYANI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3120 BALFOUR RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-5513
Mailing Address - Country:US
Mailing Address - Phone:925-634-9901
Mailing Address - Fax:925-634-1352
Practice Address - Street 1:3120 BALFOUR RD
Practice Address - Street 2:SUITE D
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-5513
Practice Address - Country:US
Practice Address - Phone:925-634-9901
Practice Address - Fax:925-634-1352
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA469231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice