Provider Demographics
NPI:1326521055
Name:RACHANA VYAS DDS INC
Entity Type:Organization
Organization Name:RACHANA VYAS DDS INC
Other - Org Name:HILLS DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHANA
Authorized Official - Middle Name:
Authorized Official - Last Name:VYAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-725-1536
Mailing Address - Street 1:5150 GRAVES AVE STE 5C
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-5005
Mailing Address - Country:US
Mailing Address - Phone:408-725-1536
Mailing Address - Fax:408-725-1021
Practice Address - Street 1:5150 GRAVES AVE STE 5C
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-5005
Practice Address - Country:US
Practice Address - Phone:408-725-1536
Practice Address - Fax:408-725-1021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56519261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental