Provider Demographics
NPI:1467574905
Name:THIND, RAVI DEV (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAVI
Middle Name:DEV
Last Name:THIND
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 1:2043 E FREMONT ST STE 1
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95205-5000
Mailing Address - Country:US
Mailing Address - Phone:209-463-2345
Mailing Address - Fax:209-463-1432
Practice Address - Street 1:2043 E FREMONT ST STE 1
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95205-5000
Practice Address - Country:US
Practice Address - Phone:209-463-2345
Practice Address - Fax:209-463-1432
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD377431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG89962-01OtherDENTI CAL ID NUMBER