Provider Demographics
NPI:1326489196
Name:SANGHANI, RUSHI J (DDS)
Entity Type:Individual
Prefix:DR
First Name:RUSHI
Middle Name:J
Last Name:SANGHANI
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 1:4232 ACCLAIM WAY
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-1884
Mailing Address - Country:US
Mailing Address - Phone:224-578-6729
Mailing Address - Fax:
Practice Address - Street 1:626 E YOSEMITE AVE
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95336-5826
Practice Address - Country:US
Practice Address - Phone:224-578-6729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-09
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29248122300000X
CA63050122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist