Provider Demographics
NPI:1255330197
Name:RANA, VINOD G (DDS)
Entity Type:Individual
Prefix:DR
First Name:VINOD
Middle Name:G
Last Name:RANA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8285 E SANTA ANA CANYON RD
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92808-2257
Mailing Address - Country:US
Mailing Address - Phone:714-974-5599
Mailing Address - Fax:714-921-2244
Practice Address - Street 1:8285 E SANTA ANA CANYON RD
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92808-2257
Practice Address - Country:US
Practice Address - Phone:714-974-5599
Practice Address - Fax:714-921-2244
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2014-07-23
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-03-28
Provider Licenses
StateLicense IDTaxonomies
CA333591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB33359-01Medicaid