Provider Demographics
NPI:1578260204
Name:RANI DEVI, FNU
Entity Type:Individual
Prefix:
First Name:FNU
Middle Name:
Last Name:RANI DEVI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RANI
Other - Middle Name:
Other - Last Name:DEVI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1201 24TH ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-2300
Mailing Address - Country:US
Mailing Address - Phone:661-281-0148
Mailing Address - Fax:
Practice Address - Street 1:5210 POMERADO WAY
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93313-5892
Practice Address - Country:US
Practice Address - Phone:661-525-8455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA108592122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist